Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $38.02 / $363.08 / $776.25	Facility		$38.02	$363.08	$776.25
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $346.74 / $501.19 / $831.76	Professional	AA	$346.74	$501.19	$831.76
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $239.88 / $338.84 / $467.74	Professional	QK	$239.88	$338.84	$467.74
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $239.88 / $346.74 / $512.86	Professional	QX	$239.88	$346.74	$512.86
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $239.88 / $316.23 / $380.19	Professional	QY	$239.88	$316.23	$380.19
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $354.81 / $588.84 / $891.25	Professional	QZ	$354.81	$588.84	$891.25
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $91.20 / $138.04 / $457.09	Professional	AA	$91.20	$138.04	$457.09
Ambetter Facility/Professional Professional Modifier QK Low / Median / High Price $42.66 / $60.26 / $89.13	Professional	QK	$42.66	$60.26	$89.13
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $42.66 / $60.26 / $229.09	Professional	QX	$42.66	$60.26	$229.09
Ambetter Facility/Professional Professional Modifier QY Low / Median / High Price $50.12 / $50.12 / $52.48	Professional	QY	$50.12	$50.12	$52.48
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $91.20 / $104.71 / $309.03	Professional	QZ	$91.20	$104.71	$309.03
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $323.59 / $512.86	Professional		$239.88	$323.59	$512.86