Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $1,820.00 / $2,520.00 / $3,500.00	Professional	AA	$1,820.00	$2,520.00	$3,500.00
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $1,120.00 / $1,870.00 / $2,990.00	Professional	AA	$1,120.00	$1,870.00	$2,990.00
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $1,050.00 / $1,050.00 / $1,950.00	Professional	QZ	$1,050.00	$1,050.00	$1,950.00
Medica Facility/Professional Facility Modifier QK Low / Median / High Price $39.50 / $39.50 / $52.00	Facility	QK	$39.50	$39.50	$52.00
Medica Facility/Professional Facility Modifier QX Low / Median / High Price $39.50 / $39.50 / $52.00	Facility	QX	$39.50	$39.50	$52.00
Medica Facility/Professional Facility Modifier QY Low / Median / High Price $39.50 / $39.50 / $52.00	Facility	QY	$39.50	$39.50	$52.00