Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $223.87 / $1,174.90 / $1,621.81	Professional	AA	$223.87	$1,174.90	$1,621.81
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $251.19 / $251.19 / $251.19	Professional	QZ	$251.19	$251.19	$251.19
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $912.01 / $912.01 / $912.01	Professional	AA	$912.01	$912.01	$912.01
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $316.23 / $316.23 / $562.34	Professional	QZ	$316.23	$316.23	$562.34
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