Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $682.50 / $916.70 / $1,145.88	Professional	AA	$682.50	$916.70	$1,145.88
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $449.18 / $655.44 / $878.11	Professional	QX	$449.18	$655.44	$878.11
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $439.05 / $605.02 / $835.62	Professional	QY	$439.05	$605.02	$835.62
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $156.08 / $1,485.21 / $1,765.28	Professional	AA	$156.08	$1,485.21	$1,765.28
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $120.54 / $216.27 / $752.00	Professional	QX	$120.54	$216.27	$752.00
Ambetter Facility/Professional Professional Modifier QY Low / Median / High Price $129.02 / $420.00 / $1,268.80	Professional	QY	$129.02	$420.00	$1,268.80
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $186.37 / $235.05 / $690.00	Professional	QZ	$186.37	$235.05	$690.00
Kaiser Permanente Facility/Professional Professional Modifier QK Low / Median / High Price $147.47 / $147.47 / $197.40	Professional	QK	$147.47	$147.47	$197.40
Kaiser Permanente Facility/Professional Professional Modifier QX Low / Median / High Price $147.47 / $147.47 / $197.40	Professional	QX	$147.47	$147.47	$197.40
Kaiser Permanente Facility/Professional Professional Modifier QY Low / Median / High Price $147.47 / $147.47 / $197.40	Professional	QY	$147.47	$147.47	$197.40
United Facility/Professional Professional Modifier QY Low / Median / High Price $85.00 / $85.00 / $405.00	Professional	QY	$85.00	$85.00	$405.00