Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $1,170.00 / $1,179.68 / $1,620.00	Professional	AA	$1,170.00	$1,179.68	$1,620.00
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $236.40 / $360.45 / $360.45	Professional	AA	$236.40	$360.45	$360.45
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $220.99 / $245.76 / $443.99	Professional	QZ	$220.99	$245.76	$443.99
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