Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $658.62 / $915.87 / $1,165.90	Professional	AA	$658.62	$915.87	$1,165.90
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $396.49 / $396.49 / $396.49	Professional	AA	$396.49	$396.49	$396.49
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $180.81 / $200.90 / $1,150.00	Professional	QZ	$180.81	$200.90	$1,150.00
Kaiser Permanente Facility/Professional Professional Modifier QK Low / Median / High Price $147.47 / $147.47 / $197.40	Professional	QK	$147.47	$147.47	$197.40
Kaiser Permanente Facility/Professional Professional Modifier QX Low / Median / High Price $147.47 / $147.47 / $197.40	Professional	QX	$147.47	$147.47	$197.40
Kaiser Permanente Facility/Professional Professional Modifier QY Low / Median / High Price $147.47 / $147.47 / $197.40	Professional	QY	$147.47	$147.47	$197.40