Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $524.81 / $954.99 / $1,995.26	Professional	AA	$524.81	$954.99	$1,995.26
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $380.19 / $588.84 / $891.25	Professional	QX	$380.19	$588.84	$891.25
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $380.19 / $645.65 / $954.99	Professional	QY	$380.19	$645.65	$954.99
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $575.44 / $602.56 / $660.69	Professional	QZ	$575.44	$602.56	$660.69
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $316.23 / $1,047.13 / $1,548.82	Professional	AA	$316.23	$1,047.13	$1,548.82
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $107.15 / $245.47 / $977.24	Professional	QX	$107.15	$245.47	$977.24
Ambetter Facility/Professional Professional Modifier QY Low / Median / High Price $676.08 / $676.08 / $741.31	Professional	QY	$676.08	$676.08	$741.31
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $186.21 / $389.05 / $1,737.80	Professional	QZ	$186.21	$389.05	$1,737.80
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