Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $816.00 / $1,048.57 / $1,317.24	Professional	AA	$816.00	$1,048.57	$1,317.24
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $321.44 / $321.44 / $321.44	Professional	AA	$321.44	$321.44	$321.44
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $341.53 / $341.53 / $341.53	Professional	QZ	$341.53	$341.53	$341.53
Kaiser Permanente Facility/Professional Professional Modifier QK Low / Median / High Price $270.35 / $270.35 / $361.90	Professional	QK	$270.35	$270.35	$361.90
Kaiser Permanente Facility/Professional Professional Modifier QX Low / Median / High Price $270.35 / $270.35 / $361.90	Professional	QX	$270.35	$270.35	$361.90
Kaiser Permanente Facility/Professional Professional Modifier QY Low / Median / High Price $270.35 / $270.35 / $361.90	Professional	QY	$270.35	$270.35	$361.90
United Facility/Professional Professional Modifier QZ Low / Median / High Price $85.00 / $85.00 / $900.00	Professional	QZ	$85.00	$85.00	$900.00