Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier QZ Low / Median / High Price $489.78 / $489.78 / $489.78	Facility	QZ	$489.78	$489.78	$489.78
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $478.63 / $891.25 / $1,230.27	Professional	AA	$478.63	$891.25	$1,230.27
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $251.19 / $354.81 / $575.44	Professional	QK	$251.19	$354.81	$575.44
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $245.47 / $363.08 / $575.44	Professional	QX	$245.47	$363.08	$575.44
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $251.19 / $295.12 / $389.05	Professional	QY	$251.19	$295.12	$389.05
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $100.00 / $338.84 / $660.69	Professional	QZ	$100.00	$338.84	$660.69
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $128.82 / $194.98 / $288.40	Professional	AA	$128.82	$194.98	$288.40
Ambetter Facility/Professional Professional Modifier QK Low / Median / High Price $60.26 / $85.11 / $190.55	Professional	QK	$60.26	$85.11	$190.55
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $58.88 / $72.44 / $128.82	Professional	QX	$58.88	$72.44	$128.82
Ambetter Facility/Professional Professional Modifier QY Low / Median / High Price $61.66 / $85.11 / $489.78	Professional	QY	$61.66	$85.11	$489.78
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $117.49 / $138.04 / $162.18	Professional	QZ	$117.49	$138.04	$162.18
BCBS Facility/Professional Facility Modifier Low / Median / High Price $33.11 / $38.90 / $52.48	Facility		$33.11	$38.90	$52.48