Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $364.03 / $1,540.00 / $2,240.00	Professional	AA	$364.03	$1,540.00	$2,240.00
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $528.74 / $650.00 / $800.00	Professional	AA	$528.74	$650.00	$800.00
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $232.68 / $509.80 / $969.00	Professional	QZ	$232.68	$509.80	$969.00
Medica Facility/Professional Facility Modifier QK Low / Median / High Price $39.50 / $39.50 / $39.50	Facility	QK	$39.50	$39.50	$39.50
Medica Facility/Professional Facility Modifier QX Low / Median / High Price $39.50 / $39.50 / $39.50	Facility	QX	$39.50	$39.50	$39.50
Medica Facility/Professional Facility Modifier QY Low / Median / High Price $39.50 / $39.50 / $39.50	Facility	QY	$39.50	$39.50	$39.50
Qualchoice Facility/Professional Professional Modifier QZ Low / Median / High Price $645.15 / $645.15 / $1,114.34	Professional	QZ	$645.15	$645.15	$1,114.34