Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $30.20 / $446.68 / $616.60	Facility		$30.20	$446.68	$616.60
Aetna Facility/Professional Facility Modifier QX Low / Median / High Price $234.42 / $245.47 / $281.84	Facility	QX	$234.42	$245.47	$281.84
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $389.05 / $776.25 / $1,096.48	Professional	AA	$389.05	$776.25	$1,096.48
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $173.78 / $346.74 / $602.56	Professional	QK	$173.78	$346.74	$602.56
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $112.20 / $346.74 / $616.60	Professional	QX	$112.20	$346.74	$616.60
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $234.42 / $331.13 / $562.34	Professional	QY	$234.42	$331.13	$562.34
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $199.53 / $524.81 / $707.95	Professional	QZ	$199.53	$524.81	$707.95
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $117.49 / $229.09 / $776.25	Professional	AA	$117.49	$229.09	$776.25
Ambetter Facility/Professional Professional Modifier QK Low / Median / High Price $67.61 / $97.72 / $346.74	Professional	QK	$67.61	$97.72	$346.74
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $61.66 / $89.13 / $331.13	Professional	QX	$61.66	$89.13	$331.13
Ambetter Facility/Professional Professional Modifier QY Low / Median / High Price $63.10 / $162.18 / $426.58	Professional	QY	$63.10	$162.18	$426.58
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $117.49 / $147.91 / $354.81	Professional	QZ	$117.49	$147.91	$354.81
Medcost Facility/Professional Facility Modifier Low / Median / High Price $33.11 / $2,238.72 / $3,981.07	Facility		$33.11	$2,238.72	$3,981.07
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $2,884.03 / $2,884.03 / $3,715.35	Facility		$2,884.03	$2,884.03	$3,715.35
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $104.71 / $104.71	Facility		$104.71	$104.71	$104.71
Wellcare Facility/Professional Facility Modifier QK Low / Median / High Price $52.48 / $52.48 / $52.48	Facility	QK	$52.48	$52.48	$52.48
Wellcare Facility/Professional Facility Modifier QX Low / Median / High Price $52.48 / $52.48 / $52.48	Facility	QX	$52.48	$52.48	$52.48
Wellcare Facility/Professional Facility Modifier QY Low / Median / High Price $52.48 / $52.48 / $52.48	Facility	QY	$52.48	$52.48	$52.48