Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $436.52 / $645.65 / $1,122.02	Professional	AA	$436.52	$645.65	$1,122.02
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $213.80 / $501.19 / $602.56	Professional	QZ	$213.80	$501.19	$602.56
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $181.97 / $524.81 / $1,258.93	Professional	AA	$181.97	$524.81	$1,258.93
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $138.04 / $213.80 / $660.69	Professional	QZ	$138.04	$213.80	$660.69
Kaiser Permanente Facility/Professional Professional Modifier QK Low / Median / High Price $97.72 / $97.72 / $131.83	Professional	QK	$97.72	$97.72	$131.83
Kaiser Permanente Facility/Professional Professional Modifier QX Low / Median / High Price $97.72 / $97.72 / $131.83	Professional	QX	$97.72	$97.72	$131.83
Kaiser Permanente Facility/Professional Professional Modifier QY Low / Median / High Price $97.72 / $97.72 / $131.83	Professional	QY	$97.72	$97.72	$131.83