Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $50.12 / $50.12	Facility		$50.12	$50.12	$50.12
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $208.93 / $549.54 / $1,258.93	Professional	AA	$208.93	$549.54	$1,258.93
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $204.17 / $309.03 / $467.74	Professional	QK	$204.17	$309.03	$467.74
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $245.47 / $338.84 / $489.78	Professional	QX	$245.47	$338.84	$489.78
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $239.88 / $295.12 / $389.05	Professional	QY	$239.88	$295.12	$389.05
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $138.04 / $575.44 / $794.33	Professional	QZ	$138.04	$575.44	$794.33
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $138.04 / $138.04 / $138.04	Professional	AA	$138.04	$138.04	$138.04
Ambetter Facility/Professional Professional Modifier QK Low / Median / High Price $89.13 / $89.13 / $89.13	Professional	QK	$89.13	$89.13	$89.13
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $89.13 / $89.13 / $89.13	Professional	QX	$89.13	$89.13	$89.13
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $138.04 / $138.04 / $239.88	Professional	QZ	$138.04	$138.04	$239.88
BCBS Facility/Professional Facility Modifier Low / Median / High Price $56,234.13 / $69,183.10 / $81,283.05	Facility		$56,234.13	$69,183.10	$81,283.05
Providence Facility/Professional Facility Modifier Low / Median / High Price $30.20 / $177.83 / $4,073.80	Facility		$30.20	$177.83	$4,073.80