Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $812.83 / $1,148.15 / $2,884.03	Professional	AA	$812.83	$1,148.15	$2,884.03
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $323.59 / $1,096.48 / $2,511.89	Professional	AA	$323.59	$1,096.48	$2,511.89
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $363.08 / $407.38 / $1,174.90	Professional	QZ	$363.08	$407.38	$1,174.90
Kaiser Permanente Facility/Professional Professional Modifier QK Low / Median / High Price $269.15 / $269.15 / $363.08	Professional	QK	$269.15	$269.15	$363.08
Kaiser Permanente Facility/Professional Professional Modifier QX Low / Median / High Price $269.15 / $269.15 / $363.08	Professional	QX	$269.15	$269.15	$363.08
Kaiser Permanente Facility/Professional Professional Modifier QY Low / Median / High Price $269.15 / $269.15 / $363.08	Professional	QY	$269.15	$269.15	$363.08