Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $232.98 / $1,680.00 / $2,100.00	Professional	AA	$232.98	$1,680.00	$2,100.00
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $350.00 / $350.00 / $350.00	Professional	QZ	$350.00	$350.00	$350.00
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $990.00 / $990.00 / $990.00	Professional	AA	$990.00	$990.00	$990.00
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $102.20 / $102.20 / $102.20	Professional	QZ	$102.20	$102.20	$102.20
Medica Facility/Professional Facility Modifier QK Low / Median / High Price $39.50 / $39.50 / $52.00	Facility	QK	$39.50	$39.50	$52.00
Medica Facility/Professional Facility Modifier QX Low / Median / High Price $39.50 / $39.50 / $52.00	Facility	QX	$39.50	$39.50	$52.00
Medica Facility/Professional Facility Modifier QY Low / Median / High Price $39.50 / $39.50 / $52.00	Facility	QY	$39.50	$39.50	$52.00