Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $724.44 / $1,122.02 / $2,630.27	Professional	AA	$724.44	$1,122.02	$2,630.27
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $616.60 / $954.99 / $1,621.81	Professional	QZ	$616.60	$954.99	$1,621.81
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $467.74 / $645.65 / $891.25	Professional	AA	$467.74	$645.65	$891.25
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $213.80 / $338.84 / $588.84	Professional	QZ	$213.80	$338.84	$588.84
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 $588.84 / $588.84 / $588.84	Professional	QZ	$588.84	$588.84	$588.84