Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier QX Low / Median / High Price $275.42 / $275.42 / $6,165.95	Facility	QX	$275.42	$275.42	$6,165.95
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $371.54 / $851.14 / $1,202.26	Professional	AA	$371.54	$851.14	$1,202.26
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $234.42 / $489.78 / $645.65	Professional	QZ	$234.42	$489.78	$645.65
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $104.71 / $169.82 / $794.33	Professional	AA	$104.71	$169.82	$794.33
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $100.00 / $194.98 / $676.08	Professional	QZ	$100.00	$194.98	$676.08
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