Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $823.90 / $1,024.52 / $1,179.68	Professional	AA	$823.90	$1,024.52	$1,179.68
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $256.10 / $256.10 / $256.10	Professional	AA	$256.10	$256.10	$256.10
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $225.28 / $225.28 / $321.44	Professional	QZ	$225.28	$225.28	$321.44
Kaiser Permanente Facility/Professional Professional Modifier QK Low / Median / High Price $172.04 / $172.04 / $230.30	Professional	QK	$172.04	$172.04	$230.30
Kaiser Permanente Facility/Professional Professional Modifier QX Low / Median / High Price $172.04 / $172.04 / $230.30	Professional	QX	$172.04	$172.04	$230.30
Kaiser Permanente Facility/Professional Professional Modifier QY Low / Median / High Price $172.04 / $172.04 / $230.30	Professional	QY	$172.04	$172.04	$230.30