Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $983.45 / $1,572.52 / $2,660.00	Professional	AA	$983.45	$1,572.52	$2,660.00
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $933.80 / $1,134.28 / $1,282.69	Professional	QZ	$933.80	$1,134.28	$1,282.69
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $561.00 / $850.00 / $1,950.00	Professional	AA	$561.00	$850.00	$1,950.00
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $278.07 / $486.62 / $695.18	Professional	QZ	$278.07	$486.62	$695.18
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 $250.60 / $250.60 / $703.80	Professional	QZ	$250.60	$250.60	$703.80