Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $370.53 / $727.13 / $1,120.00	Professional	AA	$370.53	$727.13	$1,120.00
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $575.73 / $575.73 / $575.73	Professional	QZ	$575.73	$575.73	$575.73
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $600.00 / $600.00 / $660.92	Professional	AA	$600.00	$600.00	$660.92
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