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 / $3,801.89	Professional	AA	$812.83	$1,148.15	$3,801.89
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $870.96 / $1,348.96 / $1,548.82	Professional	QZ	$870.96	$1,348.96	$1,548.82
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $630.96 / $891.25 / $1,288.25	Professional	AA	$630.96	$891.25	$1,288.25
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $251.19 / $457.09 / $977.24	Professional	QZ	$251.19	$457.09	$977.24
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 $1,122.02 / $1,122.02 / $1,122.02	Professional	QZ	$1,122.02	$1,122.02	$1,122.02