Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $532.61 / $1,078.48 / $1,104.71	Professional	AA	$532.61	$1,078.48	$1,104.71
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $748.40 / $748.40 / $748.40	Professional	QZ	$748.40	$748.40	$748.40
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $220.99 / $383.72 / $1,485.21	Professional	AA	$220.99	$383.72	$1,485.21
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $180.81 / $225.28 / $433.94	Professional	QZ	$180.81	$225.28	$433.94
Kaiser Permanente Facility/Professional Professional Modifier QK Low / Median / High Price $147.47 / $147.47 / $197.40	Professional	QK	$147.47	$147.47	$197.40
Kaiser Permanente Facility/Professional Professional Modifier QX Low / Median / High Price $147.47 / $147.47 / $197.40	Professional	QX	$147.47	$147.47	$197.40
Kaiser Permanente Facility/Professional Professional Modifier QY Low / Median / High Price $147.47 / $147.47 / $197.40	Professional	QY	$147.47	$147.47	$197.40