Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $275.42 / $389.05 / $446.68	Facility		$275.42	$389.05	$446.68
Aetna Facility/Professional Facility Modifier QX Low / Median / High Price $151.36 / $151.36 / $151.36	Facility	QX	$151.36	$151.36	$151.36
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $316.23 / $588.84 / $954.99	Professional	AA	$316.23	$588.84	$954.99
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $199.53 / $346.74 / $602.56	Professional	QK	$199.53	$346.74	$602.56
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $223.87 / $338.84 / $537.03	Professional	QX	$223.87	$338.84	$537.03
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $245.47 / $309.03 / $575.44	Professional	QY	$245.47	$309.03	$575.44
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $251.19 / $478.63 / $724.44	Professional	QZ	$251.19	$478.63	$724.44
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $117.49 / $190.55 / $478.63	Professional	AA	$117.49	$190.55	$478.63
Ambetter Facility/Professional Professional Modifier QK Low / Median / High Price $60.26 / $87.10 / $239.88	Professional	QK	$60.26	$87.10	$239.88
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $63.10 / $75.86 / $204.17	Professional	QX	$63.10	$75.86	$204.17
Ambetter Facility/Professional Professional Modifier QY Low / Median / High Price $63.10 / $67.61 / $95.50	Professional	QY	$63.10	$67.61	$95.50
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $117.49 / $165.96 / $407.38	Professional	QZ	$117.49	$165.96	$407.38
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $218.78 / $218.78 / $426.58	Facility		$218.78	$218.78	$426.58
CareSource Facility/Professional Facility Modifier Low / Median / High Price $51.29 / $64.57 / $194.98	Facility		$51.29	$64.57	$194.98