Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $3,360.00 / $3,360.00 / $3,780.00	Professional	AA	$3,360.00	$3,360.00	$3,780.00
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $876.73 / $1,348.05 / $1,348.05	Professional	QZ	$876.73	$1,348.05	$1,348.05
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $321.44 / $356.22 / $1,000.00	Professional	AA	$321.44	$356.22	$1,000.00
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $426.58 / $714.00 / $969.00	Professional	QZ	$426.58	$714.00	$969.00
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
Qualchoice Facility/Professional Professional Modifier QZ Low / Median / High Price $1,114.34 / $1,114.34 / $1,114.34	Professional	QZ	$1,114.34	$1,114.34	$1,114.34