Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $604.58 / $1,217.33 / $2,380.00	Professional	AA	$604.58	$1,217.33	$2,380.00
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $449.35 / $687.44 / $1,189.80	Professional	QZ	$449.35	$687.44	$1,189.80
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $118.86 / $350.00 / $850.00	Professional	AA	$118.86	$350.00	$850.00
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $142.63 / $285.26 / $650.00	Professional	QZ	$142.63	$285.26	$650.00
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 $227.82 / $351.90 / $527.85	Professional	QZ	$227.82	$351.90	$527.85