Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $375.00 / $375.00 / $375.00	Facility		$375.00	$375.00	$375.00
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $352.89 / $364.46 / $392.00	Professional	AA	$352.89	$364.46	$392.00
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $415.47 / $415.47 / $415.47	Professional	QX	$415.47	$415.47	$415.47
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $99.55 / $99.55 / $99.55	Professional	QZ	$99.55	$99.55	$99.55
HMSA Facility/Professional Professional Modifier QZ Low / Median / High Price $3.72 / $4.18 / $4.38	Professional	QZ	$3.72	$4.18	$4.38
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $111.32 / $175.00 / $328.00	Professional		$111.32	$175.00	$328.00