Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $446.68 / $794.33 / $1,348.96	Professional	AA	$446.68	$794.33	$1,348.96
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $316.23 / $812.83 / $1,122.02	Professional	QZ	$316.23	$812.83	$1,122.02
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $169.82 / $363.08 / $1,122.02	Professional	AA	$169.82	$363.08	$1,122.02
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $218.78 / $251.19 / $1,096.48	Professional	QZ	$218.78	$251.19	$1,096.48
Kaiser Permanente Facility/Professional Professional Modifier QK Low / Median / High Price $147.91 / $147.91 / $199.53	Professional	QK	$147.91	$147.91	$199.53
Kaiser Permanente Facility/Professional Professional Modifier QX Low / Median / High Price $147.91 / $147.91 / $199.53	Professional	QX	$147.91	$147.91	$199.53
Kaiser Permanente Facility/Professional Professional Modifier QY Low / Median / High Price $147.91 / $147.91 / $199.53	Professional	QY	$147.91	$147.91	$199.53