Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $2,041.74 / $2,041.74 / $2,041.74	Professional	QZ	$2,041.74	$2,041.74	$2,041.74
Kaiser Permanente Facility/Professional Professional Modifier QK Low / Median / High Price $194.98 / $194.98 / $263.03	Professional	QK	$194.98	$194.98	$263.03
Kaiser Permanente Facility/Professional Professional Modifier QX Low / Median / High Price $194.98 / $194.98 / $263.03	Professional	QX	$194.98	$194.98	$263.03
Kaiser Permanente Facility/Professional Professional Modifier QY Low / Median / High Price $194.98 / $194.98 / $263.03	Professional	QY	$194.98	$194.98	$263.03