Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier QX Low / Median / High Price $389.05 / $1,202.26 / $3,388.44	Facility	QX	$389.05	$1,202.26	$3,388.44
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $173.78 / $851.14 / $1,047.13	Professional	QZ	$173.78	$851.14	$1,047.13
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $234.42 / $295.12 / $1,621.81	Professional	QZ	$234.42	$295.12	$1,621.81
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