Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $672.00 / $1,179.68 / $1,620.00	Professional	AA	$672.00	$1,179.68	$1,620.00
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $275.80 / $547.64 / $743.22	Professional	AA	$275.80	$547.64	$743.22
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $217.91 / $301.35 / $488.19	Professional	QZ	$217.91	$301.35	$488.19
Kaiser Permanente Facility/Professional Professional Modifier QK Low / Median / High Price $221.20 / $221.20 / $296.10	Professional	QK	$221.20	$221.20	$296.10
Kaiser Permanente Facility/Professional Professional Modifier QX Low / Median / High Price $221.20 / $221.20 / $296.10	Professional	QX	$221.20	$221.20	$296.10
Kaiser Permanente Facility/Professional Professional Modifier QY Low / Median / High Price $221.20 / $221.20 / $296.10	Professional	QY	$221.20	$221.20	$296.10