Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier QZ Low / Median / High Price $251.46 / $251.46 / $251.46	Facility	QZ	$251.46	$251.46	$251.46
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $376.03 / $840.00 / $1,680.00	Professional	AA	$376.03	$840.00	$1,680.00
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $118.86 / $350.00 / $500.00	Professional	AA	$118.86	$350.00	$500.00
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