Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $100.45 / $100.45 / $204.00	Professional	QZ	$100.45	$100.45	$204.00
Kaiser Permanente Facility/Professional Professional Modifier QK Low / Median / High Price $98.31 / $98.31 / $131.60	Professional	QK	$98.31	$98.31	$131.60
Kaiser Permanente Facility/Professional Professional Modifier QX Low / Median / High Price $98.31 / $98.31 / $131.60	Professional	QX	$98.31	$98.31	$131.60
Kaiser Permanente Facility/Professional Professional Modifier QY Low / Median / High Price $98.31 / $98.31 / $131.60	Professional	QY	$98.31	$98.31	$131.60