Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $41.69 / $309.03	Facility		$41.69	$41.69	$309.03
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $331.13 / $426.58 / $676.08	Professional	AA	$331.13	$426.58	$676.08
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $186.21 / $363.08 / $537.03	Professional	QK	$186.21	$363.08	$537.03
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $199.53 / $363.08 / $549.54	Professional	QX	$199.53	$363.08	$549.54
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $251.19 / $309.03 / $416.87	Professional	QY	$251.19	$309.03	$416.87
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $104.71 / $331.13 / $602.56	Professional	QZ	$104.71	$331.13	$602.56
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $117.49 / $138.04 / $354.81	Professional	AA	$117.49	$138.04	$354.81
Ambetter Facility/Professional Professional Modifier QK Low / Median / High Price $69.18 / $74.13 / $100.00	Professional	QK	$69.18	$74.13	$100.00
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $67.61 / $74.13 / $204.17	Professional	QX	$67.61	$74.13	$204.17
Ambetter Facility/Professional Professional Modifier QY Low / Median / High Price $72.44 / $72.44 / $85.11	Professional	QY	$72.44	$72.44	$85.11
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $120.23 / $309.03 / $457.09	Professional	QZ	$120.23	$309.03	$457.09
Qualchoice Facility/Professional Professional Modifier AA Low / Median / High Price $354.81 / $407.38 / $549.54	Professional	AA	$354.81	$407.38	$549.54
Qualchoice Facility/Professional Professional Modifier QX Low / Median / High Price $199.53 / $199.53 / $234.42	Professional	QX	$199.53	$199.53	$234.42
Qualchoice Facility/Professional Professional Modifier QZ Low / Median / High Price $354.81 / $407.38 / $549.54	Professional	QZ	$354.81	$407.38	$549.54