Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $199.53 / $676.08 / $1,230.27	Professional	AA	$199.53	$676.08	$1,230.27
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $123.03 / $398.11 / $549.54	Professional	QZ	$123.03	$398.11	$549.54
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $100.00 / $100.00 / $100.00	Professional	QZ	$100.00	$100.00	$100.00
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