Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $176.02 / $1,120.00 / $1,820.00	Professional	AA	$176.02	$1,120.00	$1,820.00
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $669.94 / $864.59 / $1,254.58	Professional	QZ	$669.94	$864.59	$1,254.58
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $400.00 / $400.00 / $400.00	Professional	AA	$400.00	$400.00	$400.00
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $217.91 / $217.91 / $459.00	Professional	QZ	$217.91	$217.91	$459.00
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 $469.20 / $469.20 / $527.85	Professional	QZ	$469.20	$469.20	$527.85