Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $1,080.00 / $1,080.00 / $1,080.00	Professional	AA	$1,080.00	$1,080.00	$1,080.00
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $540.85 / $655.44 / $925.87	Professional	QX	$540.85	$655.44	$925.87
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $531.69 / $807.29 / $884.62	Professional	QY	$531.69	$807.29	$884.62
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $216.70 / $498.83 / $1,457.07	Professional	AA	$216.70	$498.83	$1,457.07
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $143.44 / $504.00 / $1,034.00	Professional	QX	$143.44	$504.00	$1,034.00
Ambetter Facility/Professional Professional Modifier QY Low / Median / High Price $143.44 / $245.90 / $575.00	Professional	QY	$143.44	$245.90	$575.00
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $163.84 / $261.17 / $443.99	Professional	QZ	$163.84	$261.17	$443.99
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