Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $239.88 / $1,023.29 / $1,949.84	Professional	AA	$239.88	$1,023.29	$1,949.84
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $776.25 / $776.25 / $977.24	Professional	AA	$776.25	$776.25	$977.24
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $323.59 / $346.74 / $660.69	Professional	QZ	$323.59	$346.74	$660.69
Kaiser Permanente Facility/Professional Professional Modifier QK Low / Median / High Price $173.78 / $173.78 / $229.09	Professional	QK	$173.78	$173.78	$229.09
Kaiser Permanente Facility/Professional Professional Modifier QX Low / Median / High Price $173.78 / $173.78 / $229.09	Professional	QX	$173.78	$173.78	$229.09
Kaiser Permanente Facility/Professional Professional Modifier QY Low / Median / High Price $173.78 / $173.78 / $229.09	Professional	QY	$173.78	$173.78	$229.09