Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $912.01 / $1,258.93 / $2,818.38	Professional	AA	$912.01	$1,258.93	$2,818.38
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $489.78 / $489.78 / $1,737.80	Professional	QZ	$489.78	$489.78	$1,737.80
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $120.23 / $194.98 / $724.44	Professional	AA	$120.23	$194.98	$724.44
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $97.72 / $162.18 / $562.34	Professional	QZ	$97.72	$162.18	$562.34
Medica Facility/Professional Facility Modifier QK Low / Median / High Price $39.81 / $39.81 / $52.48	Facility	QK	$39.81	$39.81	$52.48
Medica Facility/Professional Facility Modifier QX Low / Median / High Price $39.81 / $39.81 / $52.48	Facility	QX	$39.81	$39.81	$52.48
Medica Facility/Professional Facility Modifier QY Low / Median / High Price $39.81 / $39.81 / $52.48	Facility	QY	$39.81	$39.81	$52.48