Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $691.83 / $1,288.25 / $2,884.03	Professional	AA	$691.83	$1,288.25	$2,884.03
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $426.58 / $602.56 / $1,737.80	Professional	QZ	$426.58	$602.56	$1,737.80
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $181.97 / $389.05 / $676.08	Professional	AA	$181.97	$389.05	$676.08
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $154.88 / $173.78 / $776.25	Professional	QZ	$154.88	$173.78	$776.25
Medica Facility/Professional Facility Modifier QK Low / Median / High Price $39.81 / $39.81 / $52.48	Facility	QK	$39.81	$39.81	$52.48
Medica Facility/Professional Facility Modifier QX Low / Median / High Price $39.81 / $39.81 / $52.48	Facility	QX	$39.81	$39.81	$52.48
Medica Facility/Professional Facility Modifier QY Low / Median / High Price $39.81 / $39.81 / $52.48	Facility	QY	$39.81	$39.81	$52.48