Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $51.29 / $758.58 / $1,778.28	Professional	QZ	$51.29	$758.58	$1,778.28
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $138.04 / $138.04 / $138.04	Professional	QZ	$138.04	$138.04	$138.04
Medica Facility/Professional Facility Modifier QK Low / Median / High Price $39.81 / $39.81 / $52.48	Facility	QK	$39.81	$39.81	$52.48
Medica Facility/Professional Facility Modifier QX Low / Median / High Price $39.81 / $39.81 / $52.48	Facility	QX	$39.81	$39.81	$52.48
Medica Facility/Professional Facility Modifier QY Low / Median / High Price $39.81 / $39.81 / $52.48	Facility	QY	$39.81	$39.81	$52.48