Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $2,800.00 / $2,800.00 / $2,800.00	Professional	AA	$2,800.00	$2,800.00	$2,800.00
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $474.96 / $555.16 / $1,700.00	Professional	AA	$474.96	$555.16	$1,700.00
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $618.07 / $672.00 / $672.00	Professional	QZ	$618.07	$672.00	$672.00
Medica Facility/Professional Facility Modifier QK Low / Median / High Price $39.50 / $39.50 / $39.50	Facility	QK	$39.50	$39.50	$39.50
Medica Facility/Professional Facility Modifier QX Low / Median / High Price $39.50 / $39.50 / $39.50	Facility	QX	$39.50	$39.50	$39.50
Medica Facility/Professional Facility Modifier QY Low / Median / High Price $39.50 / $39.50 / $39.50	Facility	QY	$39.50	$39.50	$39.50
Qualchoice Facility/Professional Professional Modifier QZ Low / Median / High Price $938.40 / $938.40 / $1,583.55	Professional	QZ	$938.40	$938.40	$1,583.55