Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $31.62 / $263.03 / $549.54	Facility		$31.62	$263.03	$549.54
Aetna Facility/Professional Facility Modifier QX Low / Median / High Price $97.72 / $181.97 / $263.03	Facility	QX	$97.72	$181.97	$263.03
Aetna Facility/Professional Facility Modifier QZ Low / Median / High Price $1,778.28 / $3,235.94 / $3,235.94	Facility	QZ	$1,778.28	$3,235.94	$3,235.94
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $380.19 / $758.58 / $1,174.90	Professional	AA	$380.19	$758.58	$1,174.90
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $186.21 / $331.13 / $616.60	Professional	QK	$186.21	$331.13	$616.60
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $194.98 / $331.13 / $588.84	Professional	QX	$194.98	$331.13	$588.84
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $213.80 / $302.00 / $660.69	Professional	QY	$213.80	$302.00	$660.69
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $346.74 / $549.54 / $758.58	Professional	QZ	$346.74	$549.54	$758.58
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $117.49 / $186.21 / $457.09	Professional	AA	$117.49	$186.21	$457.09
Ambetter Facility/Professional Professional Modifier QK Low / Median / High Price $66.07 / $91.20 / $177.83	Professional	QK	$66.07	$91.20	$177.83
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $60.26 / $87.10 / $229.09	Professional	QX	$60.26	$87.10	$229.09
Ambetter Facility/Professional Professional Modifier QY Low / Median / High Price $67.61 / $89.13 / $131.83	Professional	QY	$67.61	$89.13	$131.83
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $117.49 / $147.91 / $275.42	Professional	QZ	$117.49	$147.91	$275.42
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $269.15 / $416.87	Professional		$151.36	$269.15	$416.87
Hally Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Facility		$100.00	$100.00	$100.00