Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $338.00 / $650.86 / $809.90	Professional	AA	$338.00	$650.86	$809.90
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $449.04 / $449.04 / $449.04	Professional	QZ	$449.04	$449.04	$449.04
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $116.22 / $391.17 / $771.39	Professional	AA	$116.22	$391.17	$771.39
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $120.54 / $160.72 / $690.00	Professional	QZ	$120.54	$160.72	$690.00
Kaiser Permanente Facility/Professional Professional Modifier QK Low / Median / High Price $98.31 / $98.31 / $131.60	Professional	QK	$98.31	$98.31	$131.60
Kaiser Permanente Facility/Professional Professional Modifier QX Low / Median / High Price $98.31 / $98.31 / $131.60	Professional	QX	$98.31	$98.31	$131.60
Kaiser Permanente Facility/Professional Professional Modifier QY Low / Median / High Price $98.31 / $98.31 / $131.60	Professional	QY	$98.31	$98.31	$131.60