Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $331.13 / $676.08 / $1,000.00	Professional	AA	$331.13	$676.08	$1,000.00
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $295.12 / $398.11 / $549.54	Professional	QK	$295.12	$398.11	$549.54
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $295.12 / $389.05 / $549.54	Professional	QX	$295.12	$389.05	$549.54
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $309.03 / $398.11 / $489.78	Professional	QY	$309.03	$398.11	$489.78
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $190.55 / $602.56 / $794.33	Professional	QZ	$190.55	$602.56	$794.33
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $158.49 / $363.08 / $1,000.00	Professional	AA	$158.49	$363.08	$1,000.00
Ambetter Facility/Professional Professional Modifier QK Low / Median / High Price $81.28 / $295.12 / $549.54	Professional	QK	$81.28	$295.12	$549.54
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $81.28 / $162.18 / $562.34	Professional	QX	$81.28	$162.18	$562.34
Ambetter Facility/Professional Professional Modifier QY Low / Median / High Price $85.11 / $181.97 / $562.34	Professional	QY	$85.11	$181.97	$562.34
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $138.04 / $208.93 / $645.65	Professional	QZ	$138.04	$208.93	$645.65
Kaiser Permanente Facility/Professional Professional Modifier QK Low / Median / High Price $147.91 / $147.91 / $199.53	Professional	QK	$147.91	$147.91	$199.53
Kaiser Permanente Facility/Professional Professional Modifier QX Low / Median / High Price $147.91 / $147.91 / $199.53	Professional	QX	$147.91	$147.91	$199.53
Kaiser Permanente Facility/Professional Professional Modifier QY Low / Median / High Price $147.91 / $147.91 / $199.53	Professional	QY	$147.91	$147.91	$199.53