Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $239.88 / $977.24	Facility		$47.86	$239.88	$977.24
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $323.59 / $575.44 / $977.24	Professional	AA	$323.59	$575.44	$977.24
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $77.62 / $309.03 / $457.09	Professional	QK	$77.62	$309.03	$457.09
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $95.50 / $302.00 / $457.09	Professional	QX	$95.50	$302.00	$457.09
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $239.88 / $295.12 / $398.11	Professional	QY	$239.88	$295.12	$398.11
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $173.78 / $478.63 / $758.58	Professional	QZ	$173.78	$478.63	$758.58
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $117.49 / $138.04 / $478.63	Professional	AA	$117.49	$138.04	$478.63
Ambetter Facility/Professional Professional Modifier QK Low / Median / High Price $66.07 / $97.72 / $288.40	Professional	QK	$66.07	$97.72	$288.40
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $60.26 / $91.20 / $323.59	Professional	QX	$60.26	$91.20	$323.59
Ambetter Facility/Professional Professional Modifier QY Low / Median / High Price $67.61 / $109.65 / $125.89	Professional	QY	$67.61	$109.65	$125.89
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $114.82 / $162.18 / $537.03	Professional	QZ	$114.82	$162.18	$537.03
CareSource Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $138.04 / $398.11	Facility		$54.95	$138.04	$398.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $61.66 / $61.66 / $61.66	Facility		$61.66	$61.66	$61.66
Cigna Facility/Professional Facility Modifier QK Low / Median / High Price $30.90 / $30.90 / $30.90	Facility	QK	$30.90	$30.90	$30.90
Cigna Facility/Professional Facility Modifier QX Low / Median / High Price $30.90 / $30.90 / $30.90	Facility	QX	$30.90	$30.90	$30.90
Cigna Facility/Professional Facility Modifier QY Low / Median / High Price $30.90 / $30.90 / $30.90	Facility	QY	$30.90	$30.90	$30.90