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 / $2,940.00	Professional	AA	$1,820.00	$2,520.00	$2,940.00
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $760.93 / $987.01 / $1,380.73	Professional	QZ	$760.93	$987.01	$1,380.73
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $608.04 / $850.00 / $900.00	Professional	AA	$608.04	$850.00	$900.00
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $332.81 / $463.45 / $1,173.00	Professional	QZ	$332.81	$463.45	$1,173.00
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 $464.74 / $879.75 / $1,348.95	Professional	QZ	$464.74	$879.75	$1,348.95