Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier QX Low / Median / High Price $66.07 / $66.07 / $66.07	Facility	QX	$66.07	$66.07	$66.07
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $134.90 / $707.95 / $933.25	Professional	AA	$134.90	$707.95	$933.25
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $102.33 / $407.38 / $489.78	Professional	QZ	$102.33	$407.38	$489.78
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $446.68 / $446.68 / $446.68	Professional	AA	$446.68	$446.68	$446.68
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $144.54 / $199.53 / $1,174.90	Professional	QZ	$144.54	$199.53	$1,174.90
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