Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $737.30 / $1,024.52 / $1,469.00	Professional	AA	$737.30	$1,024.52	$1,469.00
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $1,197.44 / $1,197.44 / $1,197.44	Professional	QZ	$1,197.44	$1,197.44	$1,197.44
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $197.00 / $261.17 / $422.09	Professional	AA	$197.00	$261.17	$422.09
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $143.36 / $204.80 / $381.71	Professional	QZ	$143.36	$204.80	$381.71
Kaiser Permanente Facility/Professional Professional Modifier QK Low / Median / High Price $147.47 / $147.47 / $197.40	Professional	QK	$147.47	$147.47	$197.40
Kaiser Permanente Facility/Professional Professional Modifier QX Low / Median / High Price $147.47 / $147.47 / $197.40	Professional	QX	$147.47	$147.47	$197.40
Kaiser Permanente Facility/Professional Professional Modifier QY Low / Median / High Price $147.47 / $147.47 / $197.40	Professional	QY	$147.47	$147.47	$197.40