Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier QZ Low / Median / High Price $186.21 / $186.21 / $186.21	Facility	QZ	$186.21	$186.21	$186.21
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $436.52 / $660.69 / $1,513.56	Professional	AA	$436.52	$660.69	$1,513.56
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $354.81 / $602.56 / $870.96	Professional	QZ	$354.81	$602.56	$870.96
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $141.25 / $302.00 / $457.09	Professional	AA	$141.25	$302.00	$457.09
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $117.49 / $181.97 / $645.65	Professional	QZ	$117.49	$181.97	$645.65
Medica Facility/Professional Facility Modifier QK Low / Median / High Price $39.81 / $39.81 / $39.81	Facility	QK	$39.81	$39.81	$39.81
Medica Facility/Professional Facility Modifier QX Low / Median / High Price $39.81 / $39.81 / $39.81	Facility	QX	$39.81	$39.81	$39.81
Medica Facility/Professional Facility Modifier QY Low / Median / High Price $39.81 / $39.81 / $39.81	Facility	QY	$39.81	$39.81	$39.81
Qualchoice Facility/Professional Professional Modifier AA Low / Median / High Price $467.74 / $524.81 / $707.95	Professional	AA	$467.74	$524.81	$707.95
Qualchoice Facility/Professional Professional Modifier QZ Low / Median / High Price $58.88 / $407.38 / $758.58	Professional	QZ	$58.88	$407.38	$758.58