Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $341.32 / $670.25 / $1,260.00	Professional	AA	$341.32	$670.25	$1,260.00
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $369.60 / $531.04 / $610.10	Professional	QZ	$369.60	$531.04	$610.10
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $139.04 / $300.00 / $400.00	Professional	AA	$139.04	$300.00	$400.00
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $99.05 / $139.04 / $306.00	Professional	QZ	$99.05	$139.04	$306.00
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 $234.60 / $234.60 / $234.60	Professional	QZ	$234.60	$234.60	$234.60