Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $700.00 / $840.00 / $2,240.00	Professional	AA	$700.00	$840.00	$2,240.00
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $558.00 / $890.53 / $928.04	Professional	QZ	$558.00	$890.53	$928.04
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $500.00 / $500.00 / $500.00	Professional	AA	$500.00	$500.00	$500.00
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $357.00 / $417.11 / $417.11	Professional	QZ	$357.00	$417.11	$417.11
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 $410.55 / $410.55 / $410.55	Professional	QZ	$410.55	$410.55	$410.55