Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $669.50 / $1,073.55 / $3,049.77	Professional	AA	$669.50	$1,073.55	$3,049.77
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $576.72 / $1,428.00 / $2,657.01	Professional	AA	$576.72	$1,428.00	$2,657.01
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $407.83 / $407.83 / $407.83	Professional	QZ	$407.83	$407.83	$407.83
Kaiser Permanente Facility/Professional Professional Modifier QK Low / Median / High Price $172.04 / $172.04 / $230.30	Professional	QK	$172.04	$172.04	$230.30
Kaiser Permanente Facility/Professional Professional Modifier QX Low / Median / High Price $172.04 / $172.04 / $230.30	Professional	QX	$172.04	$172.04	$230.30
Kaiser Permanente Facility/Professional Professional Modifier QY Low / Median / High Price $172.04 / $172.04 / $230.30	Professional	QY	$172.04	$172.04	$230.30