Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $933.25 / $1,862.09 / $3,162.28	Professional	AA	$933.25	$1,862.09	$3,162.28
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $407.38 / $691.83 / $1,230.27	Professional	QX	$407.38	$691.83	$1,230.27
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $436.52 / $812.83 / $1,949.84	Professional	QY	$436.52	$812.83	$1,949.84
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $524.81 / $616.60 / $3,388.44	Professional	QZ	$524.81	$616.60	$3,388.44
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $275.42 / $758.58 / $1,000.00	Professional	AA	$275.42	$758.58	$1,000.00
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $134.90 / $257.04 / $602.56	Professional	QX	$134.90	$257.04	$602.56
Ambetter Facility/Professional Professional Modifier QY Low / Median / High Price $257.04 / $257.04 / $323.59	Professional	QY	$257.04	$257.04	$323.59
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $199.53 / $316.23 / $707.95	Professional	QZ	$199.53	$316.23	$707.95
Medica Facility/Professional Facility Modifier QK Low / Median / High Price $39.81 / $39.81 / $52.48	Facility	QK	$39.81	$39.81	$52.48
Medica Facility/Professional Facility Modifier QX Low / Median / High Price $39.81 / $39.81 / $52.48	Facility	QX	$39.81	$39.81	$52.48
Medica Facility/Professional Facility Modifier QY Low / Median / High Price $39.81 / $39.81 / $52.48	Facility	QY	$39.81	$39.81	$52.48