Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $474.50 / $821.45 / $1,080.00	Professional	AA	$474.50	$821.45	$1,080.00
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $312.93 / $942.81 / $1,971.33	Professional	AA	$312.93	$942.81	$1,971.33
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $180.81 / $186.37 / $312.93	Professional	QZ	$180.81	$186.37	$312.93
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