Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $346.74 / $645.65 / $1,047.13	Professional	AA	$346.74	$645.65	$1,047.13
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $741.31 / $741.31 / $741.31	Professional	QZ	$741.31	$741.31	$741.31
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $120.23 / $204.17 / $1,380.38	Professional	AA	$120.23	$204.17	$1,380.38
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $158.49 / $223.87 / $512.86	Professional	QZ	$158.49	$223.87	$512.86
Kaiser Permanente Facility/Professional Professional Modifier QK Low / Median / High Price $123.03 / $123.03 / $165.96	Professional	QK	$123.03	$123.03	$165.96
Kaiser Permanente Facility/Professional Professional Modifier QX Low / Median / High Price $123.03 / $123.03 / $165.96	Professional	QX	$123.03	$123.03	$165.96
Kaiser Permanente Facility/Professional Professional Modifier QY Low / Median / High Price $123.03 / $123.03 / $165.96	Professional	QY	$123.03	$123.03	$165.96