Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $363.08 / $416.87 / $446.68	Facility		$363.08	$416.87	$446.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $47.86 / $616.60	Professional		$30.20	$47.86	$616.60
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $218.78 / $776.25 / $776.25	Professional	AA	$218.78	$776.25	$776.25
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $269.15 / $478.63 / $575.44	Professional	QX	$269.15	$478.63	$575.44
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 $363.08 / $363.08 / $363.08	Professional	QZ	$363.08	$363.08	$363.08
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $97.72 / $97.72 / $229.09	Professional	QX	$97.72	$97.72	$229.09
Ambetter Facility/Professional Professional Modifier QY Low / Median / High Price $97.72 / $204.17 / $229.09	Professional	QY	$97.72	$204.17	$229.09
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $123.03 / $144.54 / $309.03	Professional	QZ	$123.03	$144.54	$309.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $323.59 / $512.86	Professional		$204.17	$323.59	$512.86
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $104.71 / $104.71	Facility		$104.71	$104.71	$104.71
Lucent Health Facility/Professional Facility Modifier QK Low / Median / High Price $52.48 / $52.48 / $52.48	Facility	QK	$52.48	$52.48	$52.48
Lucent Health Facility/Professional Facility Modifier QX Low / Median / High Price $52.48 / $52.48 / $52.48	Facility	QX	$52.48	$52.48	$52.48
Lucent Health Facility/Professional Facility Modifier QY Low / Median / High Price $52.48 / $52.48 / $52.48	Facility	QY	$52.48	$52.48	$52.48
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,348.96 / $2,884.03 / $2,884.03	Professional		$1,348.96	$2,884.03	$2,884.03
United Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $54.95 / $85.11	Professional		$39.81	$54.95	$85.11