Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $38.02 / $38.02 / $363.08	Facility		$38.02	$38.02	$363.08
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $128.82 / $489.78 / $977.24	Professional	AA	$128.82	$489.78	$977.24
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $218.78 / $281.84 / $389.05	Professional	QX	$218.78	$281.84	$389.05
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $223.87 / $275.42 / $316.23	Professional	QY	$223.87	$275.42	$316.23
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $302.00 / $416.87 / $758.58	Professional	QZ	$302.00	$416.87	$758.58
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $93.33 / $138.04 / $588.84	Professional	AA	$93.33	$138.04	$588.84
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $50.12 / $63.10 / $229.09	Professional	QX	$50.12	$63.10	$229.09
Ambetter Facility/Professional Professional Modifier QY Low / Median / High Price $60.26 / $60.26 / $295.12	Professional	QY	$60.26	$60.26	$295.12
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $100.00 / $123.03 / $199.53	Professional	QZ	$100.00	$123.03	$199.53
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $323.59 / $512.86	Professional		$239.88	$323.59	$512.86