Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier QX Low / Median / High Price $812.83 / $1,513.56 / $8,128.31	Facility	QX	$812.83	$1,513.56	$8,128.31
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $489.78 / $954.99 / $1,659.59	Professional	AA	$489.78	$954.99	$1,659.59
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $275.42 / $588.84 / $870.96	Professional	QZ	$275.42	$588.84	$870.96
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $169.82 / $309.03 / $741.31	Professional	AA	$169.82	$309.03	$741.31
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $123.03 / $199.53 / $630.96	Professional	QZ	$123.03	$199.53	$630.96
Wellcare Facility/Professional Facility Modifier QK Low / Median / High Price $52.48 / $52.48 / $52.48	Facility	QK	$52.48	$52.48	$52.48
Wellcare Facility/Professional Facility Modifier QX Low / Median / High Price $52.48 / $52.48 / $52.48	Facility	QX	$52.48	$52.48	$52.48
Wellcare Facility/Professional Facility Modifier QY Low / Median / High Price $52.48 / $52.48 / $52.48	Facility	QY	$52.48	$52.48	$52.48