Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $45.00 / $367.86 / $482.88	Facility		$45.00	$367.86	$482.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.00 / $45.00 / $432.00	Professional		$35.00	$45.00	$432.00
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $439.20 / $507.40 / $619.20	Professional	AA	$439.20	$507.40	$619.20
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $270.89 / $301.00 / $360.00	Professional	QX	$270.89	$301.00	$360.00
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $135.10 / $405.16 / $525.99	Professional	QZ	$135.10	$405.16	$525.99
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $102.20 / $102.20 / $145.11	Professional	AA	$102.20	$102.20	$145.11
BCBS Facility/Professional Professional Modifier Low / Median / High Price $273.16 / $321.36 / $358.44	Professional		$273.16	$321.36	$358.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $225.00 / $315.00 / $425.00	Professional		$225.00	$315.00	$425.00
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
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $170.43 / $330.00 / $522.00	Professional		$170.43	$330.00	$522.00
Hally Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Facility		$100.00	$100.00	$100.00
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $229.50 / $229.50 / $270.00	Professional		$229.50	$229.50	$270.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $145.66 / $150.66 / $166.17	Professional		$145.66	$150.66	$166.17
United Facility/Professional Professional Modifier Low / Median / High Price $42.00 / $58.00 / $79.16	Professional		$42.00	$58.00	$79.16