Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $891.25 / $891.25 / $891.25	Professional	QZ	$891.25	$891.25	$891.25
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $154.88 / $154.88 / $154.88	Professional	QZ	$154.88	$154.88	$154.88
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