Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $47.86 / $389.05	Facility		$47.86	$47.86	$389.05
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $120.23 / $457.09 / $977.24	Professional	AA	$120.23	$457.09	$977.24
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $77.62 / $288.40 / $398.11	Professional	QX	$77.62	$288.40	$398.11
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $234.42 / $275.42 / $316.23	Professional	QY	$234.42	$275.42	$316.23
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $104.71 / $537.03 / $870.96	Professional	QZ	$104.71	$537.03	$870.96
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $95.50 / $173.78 / $549.54	Professional	AA	$95.50	$173.78	$549.54
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $58.88 / $97.72 / $288.40	Professional	QX	$58.88	$97.72	$288.40
Ambetter Facility/Professional Professional Modifier QY Low / Median / High Price $107.15 / $107.15 / $107.15	Professional	QY	$107.15	$107.15	$107.15
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $109.65 / $141.25 / $389.05	Professional	QZ	$109.65	$141.25	$389.05
CareSource Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $138.04 / $398.11	Facility		$54.95	$138.04	$398.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $61.66 / $61.66 / $61.66	Facility		$61.66	$61.66	$61.66
Cigna Facility/Professional Facility Modifier QK Low / Median / High Price $30.90 / $30.90 / $30.90	Facility	QK	$30.90	$30.90	$30.90
Cigna Facility/Professional Facility Modifier QX Low / Median / High Price $30.90 / $30.90 / $30.90	Facility	QX	$30.90	$30.90	$30.90
Cigna Facility/Professional Facility Modifier QY Low / Median / High Price $30.90 / $30.90 / $30.90	Facility	QY	$30.90	$30.90	$30.90