Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier QZ Low / Median / High Price $891.25 / $1,258.93 / $1,258.93	Facility	QZ	$891.25	$1,258.93	$1,258.93
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $446.68 / $645.65 / $912.01	Professional	AA	$446.68	$645.65	$912.01
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $323.59 / $416.87 / $562.34	Professional	QK	$323.59	$416.87	$562.34
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $204.17 / $407.38 / $562.34	Professional	QX	$204.17	$407.38	$562.34
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $316.23 / $398.11 / $489.78	Professional	QY	$316.23	$398.11	$489.78
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $524.81 / $660.69 / $812.83	Professional	QZ	$524.81	$660.69	$812.83
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $151.36 / $229.09 / $891.25	Professional	AA	$151.36	$229.09	$891.25
Ambetter Facility/Professional Professional Modifier QK Low / Median / High Price $87.10 / $107.15 / $338.84	Professional	QK	$87.10	$107.15	$338.84
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $81.28 / $107.15 / $338.84	Professional	QX	$81.28	$107.15	$338.84
Ambetter Facility/Professional Professional Modifier QY Low / Median / High Price $95.50 / $95.50 / $239.88	Professional	QY	$95.50	$95.50	$239.88
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $141.25 / $229.09 / $724.44	Professional	QZ	$141.25	$229.09	$724.44
Cigna Facility/Professional Professional Modifier AA Low / Median / High Price $416.87 / $416.87 / $524.81	Professional	AA	$416.87	$416.87	$524.81