Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $700.00 / $1,540.00 / $2,380.00	Professional	AA	$700.00	$1,540.00	$2,380.00
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $1,272.00 / $1,272.00 / $1,272.00	Professional	QZ	$1,272.00	$1,272.00	$1,272.00
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $420.00 / $948.00 / $1,760.00	Professional	AA	$420.00	$948.00	$1,760.00
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $176.00 / $858.00 / $1,690.00	Professional	QZ	$176.00	$858.00	$1,690.00
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