Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $549.54 / $794.33 / $977.24	Professional	QZ	$549.54	$794.33	$977.24
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $186.21 / $257.04 / $602.56	Professional	QZ	$186.21	$257.04	$602.56
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 QZ Low / Median / High Price $1,659.59 / $1,659.59 / $1,659.59	Professional	QZ	$1,659.59	$1,659.59	$1,659.59