Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $907.20 / $1,540.00 / $2,240.00	Professional	AA	$907.20	$1,540.00	$2,240.00
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $700.00 / $984.00 / $1,690.00	Professional	AA	$700.00	$984.00	$1,690.00
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $193.90 / $850.00 / $850.00	Professional	QZ	$193.90	$850.00	$850.00
Medica Facility/Professional Facility Modifier QK Low / Median / High Price $39.50 / $39.50 / $52.00	Facility	QK	$39.50	$39.50	$52.00
Medica Facility/Professional Facility Modifier QX Low / Median / High Price $39.50 / $39.50 / $52.00	Facility	QX	$39.50	$39.50	$52.00
Medica Facility/Professional Facility Modifier QY Low / Median / High Price $39.50 / $39.50 / $52.00	Facility	QY	$39.50	$39.50	$52.00