Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $107.43 / $980.00 / $1,260.00	Professional	AA	$107.43	$980.00	$1,260.00
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $392.16 / $403.87 / $482.03	Professional	QZ	$392.16	$403.87	$482.03
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $185.38 / $300.00 / $400.00	Professional	AA	$185.38	$300.00	$400.00
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $99.05 / $162.21 / $185.38	Professional	QZ	$99.05	$162.21	$185.38
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