Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $432.00 / $731.80 / $896.99	Professional	AA	$432.00	$731.80	$896.99
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $485.85 / $540.85 / $542.90	Professional	QZ	$485.85	$540.85	$542.90
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $157.60 / $391.17 / $882.64	Professional	AA	$157.60	$391.17	$882.64
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $122.88 / $184.32 / $992.97	Professional	QZ	$122.88	$184.32	$992.97
Kaiser Permanente Facility/Professional Professional Modifier QK Low / Median / High Price $122.89 / $122.89 / $164.50	Professional	QK	$122.89	$122.89	$164.50
Kaiser Permanente Facility/Professional Professional Modifier QX Low / Median / High Price $122.89 / $122.89 / $164.50	Professional	QX	$122.89	$122.89	$164.50
Kaiser Permanente Facility/Professional Professional Modifier QY Low / Median / High Price $122.89 / $122.89 / $164.50	Professional	QY	$122.89	$122.89	$164.50
United Facility/Professional Professional Modifier AA Low / Median / High Price $90.00 / $90.00 / $897.00	Professional	AA	$90.00	$90.00	$897.00
United Facility/Professional Professional Modifier QZ Low / Median / High Price $85.00 / $85.00 / $450.00	Professional	QZ	$85.00	$85.00	$450.00