Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $234.42 / $794.33 / $1,348.96	Professional	AA	$234.42	$794.33	$1,348.96
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $562.34 / $630.96 / $933.25	Professional	QZ	$562.34	$630.96	$933.25
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $457.09 / $457.09 / $457.09	Professional	AA	$457.09	$457.09	$457.09
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $147.91 / $147.91 / $147.91	Professional	QZ	$147.91	$147.91	$147.91
Kaiser Permanente Facility/Professional Professional Modifier QK Low / Median / High Price $147.91 / $147.91 / $199.53	Professional	QK	$147.91	$147.91	$199.53
Kaiser Permanente Facility/Professional Professional Modifier QX Low / Median / High Price $147.91 / $147.91 / $199.53	Professional	QX	$147.91	$147.91	$199.53
Kaiser Permanente Facility/Professional Professional Modifier QY Low / Median / High Price $147.91 / $147.91 / $199.53	Professional	QY	$147.91	$147.91	$199.53