Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier QZ Low / Median / High Price $501.19 / $501.19 / $501.19	Facility	QZ	$501.19	$501.19	$501.19
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $407.38 / $741.31 / $1,202.26	Professional	AA	$407.38	$741.31	$1,202.26
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $239.88 / $398.11 / $549.54	Professional	QK	$239.88	$398.11	$549.54
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $239.88 / $389.05 / $549.54	Professional	QX	$239.88	$389.05	$549.54
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $309.03 / $398.11 / $478.63	Professional	QY	$309.03	$398.11	$478.63
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $354.81 / $575.44 / $891.25	Professional	QZ	$354.81	$575.44	$891.25
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $141.25 / $218.78 / $676.08	Professional	AA	$141.25	$218.78	$676.08
Ambetter Facility/Professional Professional Modifier QK Low / Median / High Price $87.10 / $125.89 / $416.87	Professional	QK	$87.10	$125.89	$416.87
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $77.62 / $109.65 / $239.88	Professional	QX	$77.62	$109.65	$239.88
Ambetter Facility/Professional Professional Modifier QY Low / Median / High Price $87.10 / $141.25 / $371.54	Professional	QY	$87.10	$141.25	$371.54
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $141.25 / $213.80 / $707.95	Professional	QZ	$141.25	$213.80	$707.95
Cigna Facility/Professional Facility Modifier QK Low / Median / High Price $30.90 / $30.90 / $30.90	Facility	QK	$30.90	$30.90	$30.90
Cigna Facility/Professional Facility Modifier QX Low / Median / High Price $30.90 / $30.90 / $30.90	Facility	QX	$30.90	$30.90	$30.90
Cigna Facility/Professional Facility Modifier QY Low / Median / High Price $30.90 / $30.90 / $30.90	Facility	QY	$30.90	$30.90	$30.90