Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $478.63 / $1,023.29 / $2,089.30	Professional	AA	$478.63	$1,023.29	$2,089.30
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $138.04 / $831.76 / $954.99	Professional	QZ	$138.04	$831.76	$954.99
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $213.80 / $281.84 / $549.54	Professional	AA	$213.80	$281.84	$549.54
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $199.53 / $239.88 / $602.56	Professional	QZ	$199.53	$239.88	$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