Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $977.24 / $1,202.26 / $3,630.78	Professional	AA	$977.24	$1,202.26	$3,630.78
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $436.52 / $436.52 / $478.63	Professional	QZ	$436.52	$436.52	$478.63
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $549.54 / $549.54 / $549.54	Professional	AA	$549.54	$549.54	$549.54
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $117.49 / $117.49 / $147.91	Professional	QZ	$117.49	$117.49	$147.91
Medica Facility/Professional Facility Modifier QK Low / Median / High Price $39.81 / $39.81 / $52.48	Facility	QK	$39.81	$39.81	$52.48
Medica Facility/Professional Facility Modifier QX Low / Median / High Price $39.81 / $39.81 / $52.48	Facility	QX	$39.81	$39.81	$52.48
Medica Facility/Professional Facility Modifier QY Low / Median / High Price $39.81 / $39.81 / $52.48	Facility	QY	$39.81	$39.81	$52.48