Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $1,659.59 / $2,454.71 / $2,818.38	Professional	AA	$1,659.59	$2,454.71	$2,818.38
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $977.24 / $977.24 / $977.24	Professional	QZ	$977.24	$977.24	$977.24
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $933.25 / $933.25 / $1,148.15	Professional	AA	$933.25	$933.25	$1,148.15
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $416.87 / $812.83 / $1,380.38	Professional	QZ	$416.87	$812.83	$1,380.38
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 $933.25 / $933.25 / $1,584.89	Professional	QZ	$933.25	$933.25	$1,584.89