Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $283.24 / $481.00 / $915.87	Professional	AA	$283.24	$481.00	$915.87
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $334.60 / $421.68 / $552.36	Professional	QK	$334.60	$421.68	$552.36
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $325.43 / $412.52 / $560.70	Professional	QX	$325.43	$412.52	$560.70
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $330.47 / $396.05 / $467.38	Professional	QY	$330.47	$396.05	$467.38
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $140.63 / $487.50 / $673.56	Professional	QZ	$140.63	$487.50	$673.56
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $193.54 / $672.00 / $992.97	Professional	AA	$193.54	$672.00	$992.97
Ambetter Facility/Professional Professional Modifier QK Low / Median / High Price $78.80 / $153.49 / $538.20	Professional	QK	$78.80	$153.49	$538.20
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $81.92 / $180.22 / $846.00	Professional	QX	$81.92	$180.22	$846.00
Ambetter Facility/Professional Professional Modifier QY Low / Median / High Price $70.31 / $156.47 / $478.40	Professional	QY	$70.31	$156.47	$478.40
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $160.72 / $184.32 / $742.00	Professional	QZ	$160.72	$184.32	$742.00
Kaiser Permanente Facility/Professional Professional Modifier QK Low / Median / High Price $147.47 / $147.47 / $197.40	Professional	QK	$147.47	$147.47	$197.40
Kaiser Permanente Facility/Professional Professional Modifier QX Low / Median / High Price $147.47 / $147.47 / $197.40	Professional	QX	$147.47	$147.47	$197.40
Kaiser Permanente Facility/Professional Professional Modifier QY Low / Median / High Price $147.47 / $147.47 / $197.40	Professional	QY	$147.47	$147.47	$197.40
United Facility/Professional Professional Modifier QY Low / Median / High Price $85.00 / $85.00 / $85.00	Professional	QY	$85.00	$85.00	$85.00