Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $350.00 / $350.00 / $650.00	Professional	QZ	$350.00	$350.00	$650.00
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