Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $40.00 / $48.00 / $408.00	Facility		$40.00	$48.00	$408.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.00 / $42.00 / $61.00	Professional		$38.00	$42.00	$61.00
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $78.04 / $78.04 / $78.04	Professional	QX	$78.04	$78.04	$78.04
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $170.71 / $191.20 / $218.51	Professional	QZ	$170.71	$191.20	$218.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $237.50 / $285.00 / $400.00	Professional		$237.50	$285.00	$400.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $310.00 / $310.00 / $310.00	Professional		$310.00	$310.00	$310.00
United Facility/Professional Professional Modifier Low / Median / High Price $40.00 / $50.00 / $60.00	Professional		$40.00	$50.00	$60.00