Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $25.12 / $38.02 / $446.68	Facility		$25.12	$38.02	$446.68
Aetna Facility/Professional Facility Modifier AA Low / Median / High Price $501.19 / $501.19 / $501.19	Facility	AA	$501.19	$501.19	$501.19
Aetna Facility/Professional Facility Modifier QK Low / Median / High Price $245.47 / $245.47 / $660.69	Facility	QK	$245.47	$245.47	$660.69
Aetna Facility/Professional Facility Modifier QX Low / Median / High Price $74.13 / $158.49 / $741.31	Facility	QX	$74.13	$158.49	$741.31
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $257.04 / $691.83 / $1,202.26	Professional	AA	$257.04	$691.83	$1,202.26
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $190.55 / $389.05 / $676.08	Professional	QK	$190.55	$389.05	$676.08
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $147.91 / $398.11 / $741.31	Professional	QX	$147.91	$398.11	$741.31
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $190.55 / $346.74 / $524.81	Professional	QY	$190.55	$346.74	$524.81
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $275.42 / $512.86 / $691.83	Professional	QZ	$275.42	$512.86	$691.83
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $138.04 / $181.97 / $457.09	Professional	AA	$138.04	$181.97	$457.09
Ambetter Facility/Professional Professional Modifier QK Low / Median / High Price $66.07 / $89.13 / $302.00	Professional	QK	$66.07	$89.13	$302.00
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $70.79 / $100.00 / $269.15	Professional	QX	$70.79	$100.00	$269.15
Ambetter Facility/Professional Professional Modifier QY Low / Median / High Price $63.10 / $107.15 / $323.59	Professional	QY	$63.10	$107.15	$323.59
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $117.49 / $158.49 / $407.38	Professional	QZ	$117.49	$158.49	$407.38
BCBS Facility/Professional Professional Modifier AA Low / Median / High Price $186.21 / $302.00 / $407.38	Professional	AA	$186.21	$302.00	$407.38
BCBS Facility/Professional Professional Modifier QX Low / Median / High Price $50.12 / $104.71 / $190.55	Professional	QX	$50.12	$104.71	$190.55
BCBS Facility/Professional Professional Modifier QZ Low / Median / High Price $120.23 / $208.93 / $323.59	Professional	QZ	$120.23	$208.93	$323.59
Medcost Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $2,570.40 / $5,623.41	Facility		$50.12	$2,570.40	$5,623.41