Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $758.58 / $758.58 / $758.58	Professional	QZ	$758.58	$758.58	$758.58
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $162.18 / $204.17 / $512.86	Professional	QZ	$162.18	$204.17	$512.86
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