Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $252.00 / $390.00 / $534.05	Facility		$252.00	$390.00	$534.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.00 / $42.00 / $453.66	Professional		$38.00	$42.00	$453.66
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $387.60 / $387.60 / $1,260.00	Professional	AA	$387.60	$387.60	$1,260.00
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $306.00 / $306.00 / $408.00	Professional	QZ	$306.00	$306.00	$408.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $105.92 / $307.50 / $458.70	Professional		$105.92	$307.50	$458.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $230.00 / $315.00 / $417.30	Professional		$230.00	$315.00	$417.30
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,764.00 / $2,730.00 / $3,041.64	Facility		$1,764.00	$2,730.00	$3,041.64
Medica Facility/Professional Facility Modifier QK Low / Median / High Price $39.50 / $39.50 / $39.50	Facility	QK	$39.50	$39.50	$39.50
Medica Facility/Professional Facility Modifier QX Low / Median / High Price $39.50 / $39.50 / $39.50	Facility	QX	$39.50	$39.50	$39.50
Medica Facility/Professional Facility Modifier QY Low / Median / High Price $39.50 / $39.50 / $39.50	Facility	QY	$39.50	$39.50	$39.50
Medica Facility/Professional Professional Modifier Low / Median / High Price $40.00 / $59.00 / $1,351.68	Professional		$40.00	$59.00	$1,351.68
Qualchoice Facility/Professional Professional Modifier QX Low / Median / High Price $175.95 / $175.95 / $175.95	Professional	QX	$175.95	$175.95	$175.95
Qualchoice Facility/Professional Professional Modifier QZ Low / Median / High Price $159.47 / $351.90 / $469.20	Professional	QZ	$159.47	$351.90	$469.20
United Facility/Professional Professional Modifier Low / Median / High Price $39.00 / $57.00 / $77.56	Professional		$39.00	$57.00	$77.56