Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $676.08 / $1,174.90 / $2,398.83	Professional	AA	$676.08	$1,174.90	$2,398.83
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $331.13 / $602.56 / $891.25	Professional	QX	$331.13	$602.56	$891.25
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $302.00 / $549.54 / $831.76	Professional	QY	$302.00	$549.54	$831.76
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $446.68 / $630.96 / $1,202.26	Professional	QZ	$446.68	$630.96	$1,202.26
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $162.18 / $275.42 / $1,047.13	Professional	AA	$162.18	$275.42	$1,047.13
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $12.88 / $173.78 / $676.08	Professional	QX	$12.88	$173.78	$676.08
Ambetter Facility/Professional Professional Modifier QY Low / Median / High Price $85.11 / $85.11 / $125.89	Professional	QY	$85.11	$85.11	$125.89
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $251.19 / $363.08 / $1,202.26	Professional	QZ	$251.19	$363.08	$1,202.26
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