Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $30.20 / $346.74 / $616.60	Facility		$30.20	$346.74	$616.60
Aetna Facility/Professional Facility Modifier QX Low / Median / High Price $234.42 / $380.19 / $436.52	Facility	QX	$234.42	$380.19	$436.52
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $389.05 / $758.58 / $1,000.00	Professional	AA	$389.05	$758.58	$1,000.00
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $223.87 / $363.08 / $602.56	Professional	QK	$223.87	$363.08	$602.56
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $229.09 / $354.81 / $630.96	Professional	QX	$229.09	$354.81	$630.96
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $234.42 / $354.81 / $549.54	Professional	QY	$234.42	$354.81	$549.54
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $269.15 / $489.78 / $645.65	Professional	QZ	$269.15	$489.78	$645.65
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $100.00 / $144.54 / $549.54	Professional	AA	$100.00	$144.54	$549.54
Ambetter Facility/Professional Professional Modifier QK Low / Median / High Price $48.98 / $58.88 / $302.00	Professional	QK	$48.98	$58.88	$302.00
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $48.98 / $70.79 / $346.74	Professional	QX	$48.98	$70.79	$346.74
Ambetter Facility/Professional Professional Modifier QY Low / Median / High Price $50.12 / $85.11 / $933.25	Professional	QY	$50.12	$85.11	$933.25
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $97.72 / $117.49 / $524.81	Professional	QZ	$97.72	$117.49	$524.81
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 $2,238.72 / $2,238.72 / $2,691.53	Facility		$2,238.72	$2,238.72	$2,691.53
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