Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $446.68 / $724.44 / $1,318.26	Professional	AA	$446.68	$724.44	$1,318.26
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $1,445.44 / $1,445.44 / $1,698.24	Professional	QZ	$1,445.44	$1,445.44	$1,698.24
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $851.14 / $851.14 / $851.14	Professional	AA	$851.14	$851.14	$851.14
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $181.97 / $181.97 / $218.78	Professional	QZ	$181.97	$181.97	$218.78
Kaiser Permanente Facility/Professional Professional Modifier QK Low / Median / High Price $123.03 / $123.03 / $165.96	Professional	QK	$123.03	$123.03	$165.96
Kaiser Permanente Facility/Professional Professional Modifier QX Low / Median / High Price $123.03 / $123.03 / $165.96	Professional	QX	$123.03	$123.03	$165.96
Kaiser Permanente Facility/Professional Professional Modifier QY Low / Median / High Price $123.03 / $123.03 / $165.96	Professional	QY	$123.03	$123.03	$165.96