Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $898.08 / $898.08 / $898.08	Professional	QZ	$898.08	$898.08	$898.08
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $200.90 / $261.17 / $325.45	Professional	QZ	$200.90	$261.17	$325.45
Kaiser Permanente Facility/Professional Professional Modifier QK Low / Median / High Price $172.04 / $172.04 / $230.30	Professional	QK	$172.04	$172.04	$230.30
Kaiser Permanente Facility/Professional Professional Modifier QX Low / Median / High Price $172.04 / $172.04 / $230.30	Professional	QX	$172.04	$172.04	$230.30
Kaiser Permanente Facility/Professional Professional Modifier QY Low / Median / High Price $172.04 / $172.04 / $230.30	Professional	QY	$172.04	$172.04	$230.30