Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $275.42 / $707.95 / $1,318.26	Professional	AA	$275.42	$707.95	$1,318.26
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $602.56 / $794.33 / $1,445.44	Professional	QZ	$602.56	$794.33	$1,445.44
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $158.49 / $588.84 / $1,047.13	Professional	AA	$158.49	$588.84	$1,047.13
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $158.49 / $295.12 / $1,318.26	Professional	QZ	$158.49	$295.12	$1,318.26
Kaiser Permanente Facility/Professional Professional Modifier QK Low / Median / High Price $97.72 / $97.72 / $131.83	Professional	QK	$97.72	$97.72	$131.83
Kaiser Permanente Facility/Professional Professional Modifier QX Low / Median / High Price $97.72 / $97.72 / $131.83	Professional	QX	$97.72	$97.72	$131.83
Kaiser Permanente Facility/Professional Professional Modifier QY Low / Median / High Price $97.72 / $97.72 / $131.83	Professional	QY	$97.72	$97.72	$131.83