Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $354.81 / $741.31 / $1,122.02	Professional	AA	$354.81	$741.31	$1,122.02
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $263.03 / $691.83 / $831.76	Professional	QZ	$263.03	$691.83	$831.76
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $173.78 / $645.65 / $1,348.96	Professional	AA	$173.78	$645.65	$1,348.96
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $154.88 / $234.42 / $891.25	Professional	QZ	$154.88	$234.42	$891.25
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