Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $426.58 / $532.97 / $969.00	Professional	QZ	$426.58	$532.97	$969.00
Medica Facility/Professional Facility Modifier QK Low / Median / High Price $39.50 / $39.50 / $39.50	Facility	QK	$39.50	$39.50	$39.50
Medica Facility/Professional Facility Modifier QX Low / Median / High Price $39.50 / $39.50 / $39.50	Facility	QX	$39.50	$39.50	$39.50
Medica Facility/Professional Facility Modifier QY Low / Median / High Price $39.50 / $39.50 / $39.50	Facility	QY	$39.50	$39.50	$39.50
Qualchoice Facility/Professional Professional Modifier QZ Low / Median / High Price $1,055.70 / $1,055.70 / $1,114.34	Professional	QZ	$1,055.70	$1,055.70	$1,114.34