Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $371.54 / $537.03	Facility		$44.67	$371.54	$537.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $52.48 / $645.65	Professional		$34.67	$52.48	$645.65
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $478.63 / $616.60 / $2,630.27	Professional	AA	$478.63	$616.60	$2,630.27
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $269.15 / $363.08 / $549.54	Professional	QX	$269.15	$363.08	$549.54
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $295.12 / $309.03 / $489.78	Professional	QY	$295.12	$309.03	$489.78
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $134.90 / $436.52 / $524.81	Professional	QZ	$134.90	$436.52	$524.81
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $97.72 / $97.72 / $97.72	Professional	QX	$97.72	$97.72	$97.72
Ambetter Facility/Professional Professional Modifier QY Low / Median / High Price $97.72 / $97.72 / $97.72	Professional	QY	$97.72	$97.72	$97.72
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $117.49 / $173.78 / $389.05	Professional	QZ	$117.49	$173.78	$389.05
BCBS Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $323.59 / $354.81	Professional		$275.42	$323.59	$354.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $309.03 / $501.19	Professional		$223.87	$309.03	$501.19
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $323.59 / $501.19	Professional		$169.82	$323.59	$501.19
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 $229.09 / $269.15 / $269.15	Professional		$229.09	$269.15	$269.15
United Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $54.95 / $77.62	Professional		$39.81	$54.95	$77.62