Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $524.81 / $1,023.29 / $1,862.09	Professional	AA	$524.81	$1,023.29	$1,862.09
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $1,202.26 / $1,202.26 / $1,202.26	Professional	QZ	$1,202.26	$1,202.26	$1,202.26
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $316.23 / $912.01 / $1,548.82	Professional	AA	$316.23	$912.01	$1,548.82
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $144.54 / $467.74 / $912.01	Professional	QZ	$144.54	$467.74	$912.01
Kaiser Permanente Facility/Professional Professional Modifier QK Low / Median / High Price $147.91 / $147.91 / $199.53	Professional	QK	$147.91	$147.91	$199.53
Kaiser Permanente Facility/Professional Professional Modifier QX Low / Median / High Price $147.91 / $147.91 / $199.53	Professional	QX	$147.91	$147.91	$199.53
Kaiser Permanente Facility/Professional Professional Modifier QY Low / Median / High Price $147.91 / $147.91 / $199.53	Professional	QY	$147.91	$147.91	$199.53