Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $462.80 / $1,260.00 / $1,820.00	Professional	AA	$462.80	$1,260.00	$1,820.00
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $180.99 / $1,100.00 / $1,170.00	Professional	AA	$180.99	$1,100.00	$1,170.00
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $126.25 / $630.00 / $1,690.00	Professional	QZ	$126.25	$630.00	$1,690.00
Medica Facility/Professional Facility Modifier QK Low / Median / High Price $39.50 / $39.50 / $52.00	Facility	QK	$39.50	$39.50	$52.00
Medica Facility/Professional Facility Modifier QX Low / Median / High Price $39.50 / $39.50 / $52.00	Facility	QX	$39.50	$39.50	$52.00
Medica Facility/Professional Facility Modifier QY Low / Median / High Price $39.50 / $39.50 / $52.00	Facility	QY	$39.50	$39.50	$52.00