Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $758.58 / $1,548.82 / $2,884.03	Professional	AA	$758.58	$1,548.82	$2,884.03
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $436.52 / $707.95 / $1,230.27	Professional	QX	$436.52	$707.95	$1,230.27
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $398.11 / $776.25 / $1,778.28	Professional	QY	$398.11	$776.25	$1,778.28
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $467.74 / $616.60 / $1,258.93	Professional	QZ	$467.74	$616.60	$1,258.93
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $426.58 / $933.25 / $1,819.70	Professional	AA	$426.58	$933.25	$1,819.70
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $229.09 / $354.81 / $3,630.78	Professional	QX	$229.09	$354.81	$3,630.78
Ambetter Facility/Professional Professional Modifier QY Low / Median / High Price $229.09 / $229.09 / $229.09	Professional	QY	$229.09	$229.09	$229.09
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $457.09 / $524.81 / $758.58	Professional	QZ	$457.09	$524.81	$758.58
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
Providence Facility/Professional Professional Modifier QX Low / Median / High Price $181.97 / $181.97 / $181.97	Professional	QX	$181.97	$181.97	$181.97
Providence Facility/Professional Professional Modifier QY Low / Median / High Price $181.97 / $181.97 / $181.97	Professional	QY	$181.97	$181.97	$181.97