Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $213.80 / $812.83 / $1,071.52	Professional	AA	$213.80	$812.83	$1,071.52
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $138.04 / $831.76 / $831.76	Professional	QZ	$138.04	$831.76	$831.76
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $223.87 / $288.40 / $645.65	Professional	AA	$223.87	$288.40	$645.65
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $199.53 / $263.03 / $1,023.29	Professional	QZ	$199.53	$263.03	$1,023.29
Kaiser Permanente Facility/Professional Professional Modifier QK Low / Median / High Price $147.91 / $147.91 / $199.53	Professional	QK	$147.91	$147.91	$199.53
Kaiser Permanente Facility/Professional Professional Modifier QX Low / Median / High Price $147.91 / $147.91 / $199.53	Professional	QX	$147.91	$147.91	$199.53
Kaiser Permanente Facility/Professional Professional Modifier QY Low / Median / High Price $147.91 / $147.91 / $199.53	Professional	QY	$147.91	$147.91	$199.53