Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $40.00 / $45.00 / $798.00	Facility		$40.00	$45.00	$798.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $45.00 / $450.00	Professional		$30.00	$45.00	$450.00
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $145.11 / $145.11 / $145.11	Professional	AA	$145.11	$145.11	$145.11
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $336.00 / $336.00 / $940.00	Professional	QX	$336.00	$336.00	$940.00
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $124.38 / $145.11 / $1,690.00	Professional	QZ	$124.38	$145.11	$1,690.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $240.00 / $350.00 / $515.00	Professional		$240.00	$350.00	$515.00
Cigna Facility/Professional Professional Modifier QX Low / Median / High Price $180.00 / $180.00 / $180.00	Professional	QX	$180.00	$180.00	$180.00
Cigna Facility/Professional Professional Modifier QY Low / Median / High Price $180.00 / $180.00 / $180.00	Professional	QY	$180.00	$180.00	$180.00
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $120.00 / $228.00 / $324.00	Professional		$120.00	$228.00	$324.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $69.59 / $183.75 / $711.65	Professional		$69.59	$183.75	$711.65
United Facility/Professional Professional Modifier Low / Median / High Price $48.00 / $60.00 / $87.98	Professional		$48.00	$60.00	$87.98