Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $347.10 / $840.00 / $1,526.25	Professional	AA	$347.10	$840.00	$1,526.25
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $318.18 / $318.18 / $318.18	Professional	QZ	$318.18	$318.18	$318.18
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $420.00 / $765.00 / $1,430.00	Professional	AA	$420.00	$765.00	$1,430.00
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $112.22 / $630.00 / $1,300.00	Professional	QZ	$112.22	$630.00	$1,300.00
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
United Facility/Professional Professional Modifier AA Low / Median / High Price $480.00 / $480.00 / $480.00	Professional	AA	$480.00	$480.00	$480.00
United Facility/Professional Professional Modifier QZ Low / Median / High Price $632.45 / $632.45 / $632.45	Professional	QZ	$632.45	$632.45	$632.45