Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $346.74 / $371.54	Facility		$302.00	$346.74	$371.54
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $436.52 / $676.08 / $1,000.00	Professional	AA	$436.52	$676.08	$1,000.00
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $93.33 / $346.74 / $575.44	Professional	QK	$93.33	$346.74	$575.44
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $147.91 / $354.81 / $645.65	Professional	QX	$147.91	$354.81	$645.65
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $239.88 / $331.13 / $524.81	Professional	QY	$239.88	$331.13	$524.81
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $128.82 / $457.09 / $758.58	Professional	QZ	$128.82	$457.09	$758.58
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $117.49 / $134.90 / $354.81	Professional	AA	$117.49	$134.90	$354.81
Ambetter Facility/Professional Professional Modifier QK Low / Median / High Price $60.26 / $70.79 / $158.49	Professional	QK	$60.26	$70.79	$158.49
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $60.26 / $77.62 / $194.98	Professional	QX	$60.26	$77.62	$194.98
Ambetter Facility/Professional Professional Modifier QY Low / Median / High Price $63.10 / $100.00 / $229.09	Professional	QY	$63.10	$100.00	$229.09
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $117.49 / $141.25 / $363.08	Professional	QZ	$117.49	$141.25	$363.08
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $104.71 / $104.71	Facility		$104.71	$104.71	$104.71
Lucent Health Facility/Professional Facility Modifier QK Low / Median / High Price $52.48 / $52.48 / $52.48	Facility	QK	$52.48	$52.48	$52.48
Lucent Health Facility/Professional Facility Modifier QX Low / Median / High Price $52.48 / $52.48 / $52.48	Facility	QX	$52.48	$52.48	$52.48
Lucent Health Facility/Professional Facility Modifier QY Low / Median / High Price $52.48 / $52.48 / $52.48	Facility	QY	$52.48	$52.48	$52.48