Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $241.21 / $1,055.04 / $1,960.00	Professional	AA	$241.21	$1,055.04	$1,960.00
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $612.75 / $824.01 / $1,150.14	Professional	QZ	$612.75	$824.01	$1,150.14
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $231.73 / $450.00 / $650.00	Professional	AA	$231.73	$450.00	$650.00
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $178.29 / $277.33 / $585.00	Professional	QZ	$178.29	$277.33	$585.00
Medica Facility/Professional Facility Modifier QK Low / Median / High Price $39.50 / $39.50 / $39.50	Facility	QK	$39.50	$39.50	$39.50
Medica Facility/Professional Facility Modifier QX Low / Median / High Price $39.50 / $39.50 / $39.50	Facility	QX	$39.50	$39.50	$39.50
Medica Facility/Professional Facility Modifier QY Low / Median / High Price $39.50 / $39.50 / $39.50	Facility	QY	$39.50	$39.50	$39.50
Qualchoice Facility/Professional Professional Modifier QZ Low / Median / High Price $182.25 / $410.55 / $645.15	Professional	QZ	$182.25	$410.55	$645.15