Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $422.50 / $804.98 / $1,114.16	Professional	AA	$422.50	$804.98	$1,114.16
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $316.42 / $742.60 / $1,150.00	Professional	AA	$316.42	$742.60	$1,150.00
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $140.63 / $160.72 / $233.04	Professional	QZ	$140.63	$160.72	$233.04
Kaiser Permanente Facility/Professional Professional Modifier QK Low / Median / High Price $98.31 / $98.31 / $131.60	Professional	QK	$98.31	$98.31	$131.60
Kaiser Permanente Facility/Professional Professional Modifier QX Low / Median / High Price $98.31 / $98.31 / $131.60	Professional	QX	$98.31	$98.31	$131.60
Kaiser Permanente Facility/Professional Professional Modifier QY Low / Median / High Price $98.31 / $98.31 / $131.60	Professional	QY	$98.31	$98.31	$131.60