Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $107.43 / $980.00 / $1,260.00	Professional	AA	$107.43	$980.00	$1,260.00
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $618.00 / $618.00 / $618.00	Professional	AA	$618.00	$618.00	$618.00
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $420.00 / $420.00 / $420.00	Professional	QZ	$420.00	$420.00	$420.00
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