Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $700.00 / $1,260.00 / $2,100.00	Professional	AA	$700.00	$1,260.00	$2,100.00
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $1,113.00 / $1,113.00 / $1,272.00	Professional	QZ	$1,113.00	$1,113.00	$1,272.00
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $550.00 / $660.00 / $1,560.00	Professional	AA	$550.00	$660.00	$1,560.00
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $560.00 / $910.00 / $1,287.00	Professional	QZ	$560.00	$910.00	$1,287.00
Medica Facility/Professional Facility Modifier QK Low / Median / High Price $39.50 / $39.50 / $52.00	Facility	QK	$39.50	$39.50	$52.00
Medica Facility/Professional Facility Modifier QX Low / Median / High Price $39.50 / $39.50 / $52.00	Facility	QX	$39.50	$39.50	$52.00
Medica Facility/Professional Facility Modifier QY Low / Median / High Price $39.50 / $39.50 / $52.00	Facility	QY	$39.50	$39.50	$52.00