Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $190.72 / $1,400.00 / $2,100.00	Professional	AA	$190.72	$1,400.00	$2,100.00
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $400.00 / $400.00 / $400.00	Professional	QZ	$400.00	$400.00	$400.00
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $240.48 / $902.00 / $1,442.00	Professional	AA	$240.48	$902.00	$1,442.00
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $213.29 / $840.00 / $840.00	Professional	QZ	$213.29	$840.00	$840.00
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