Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $620.91 / $1,540.00 / $2,240.00	Professional	AA	$620.91	$1,540.00	$2,240.00
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $964.06 / $964.06 / $964.06	Professional	QZ	$964.06	$964.06	$964.06
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $254.90 / $254.90 / $612.00	Professional	QZ	$254.90	$254.90	$612.00
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 $703.80 / $703.80 / $703.80	Professional	QZ	$703.80	$703.80	$703.80