Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $181.97 / $831.76 / $1,412.54	Professional	AA	$181.97	$831.76	$1,412.54
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $660.69 / $724.44 / $1,122.02	Professional	QZ	$660.69	$724.44	$1,122.02
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $208.93 / $446.68 / $645.65	Professional	AA	$208.93	$446.68	$645.65
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $141.25 / $229.09 / $407.38	Professional	QZ	$141.25	$229.09	$407.38
Medica Facility/Professional Facility Modifier QK Low / Median / High Price $39.81 / $39.81 / $39.81	Facility	QK	$39.81	$39.81	$39.81
Medica Facility/Professional Facility Modifier QX Low / Median / High Price $39.81 / $39.81 / $39.81	Facility	QX	$39.81	$39.81	$39.81
Medica Facility/Professional Facility Modifier QY Low / Median / High Price $39.81 / $39.81 / $39.81	Facility	QY	$39.81	$39.81	$39.81
Qualchoice Facility/Professional Professional Modifier QZ Low / Median / High Price $467.74 / $467.74 / $467.74	Professional	QZ	$467.74	$467.74	$467.74