Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $746.27 / $1,540.00 / $2,240.00	Professional	AA	$746.27	$1,540.00	$2,240.00
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $658.36 / $907.41 / $1,348.05	Professional	QZ	$658.36	$907.41	$1,348.05
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $261.17 / $650.00 / $850.00	Professional	AA	$261.17	$650.00	$850.00
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $204.80 / $407.19 / $650.00	Professional	QZ	$204.80	$407.19	$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 $586.50 / $586.50 / $762.45	Professional	QZ	$586.50	$586.50	$762.45