Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $30.20 / $30.20 / $239.88	Facility		$30.20	$30.20	$239.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $44.67 / $537.03	Professional		$30.20	$44.67	$537.03
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $616.60 / $616.60 / $616.60	Professional	AA	$616.60	$616.60	$616.60
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $269.15 / $371.54 / $549.54	Professional	QX	$269.15	$371.54	$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 $120.23 / $138.04 / $363.08	Professional	QZ	$120.23	$138.04	$363.08
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $77.62 / $77.62 / $151.36	Professional	QX	$77.62	$77.62	$151.36
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $117.49 / $141.25 / $354.81	Professional	QZ	$117.49	$141.25	$354.81
BCBS Facility/Professional Professional Modifier AA Low / Median / High Price $186.21 / $302.00 / $407.38	Professional	AA	$186.21	$302.00	$407.38
BCBS Facility/Professional Professional Modifier QX Low / Median / High Price $50.12 / $104.71 / $190.55	Professional	QX	$50.12	$104.71	$190.55
BCBS Facility/Professional Professional Modifier QZ Low / Median / High Price $120.23 / $208.93 / $323.59	Professional	QZ	$120.23	$208.93	$323.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $338.84 / $630.96	Professional		$218.78	$338.84	$630.96
Medcost Facility/Professional Facility Modifier Low / Median / High Price $1,949.84 / $3,019.95 / $5,623.41	Facility		$1,949.84	$3,019.95	$5,623.41
Molina Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $302.00 / $501.19	Professional		$95.50	$302.00	$501.19
United Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $58.88 / $79.43	Professional		$42.66	$58.88	$79.43