Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $204.58 / $737.30 / $1,024.52	Professional	AA	$204.58	$737.30	$1,024.52
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $898.08 / $898.08 / $972.92	Professional	QZ	$898.08	$898.08	$972.92
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $334.90 / $1,273.04 / $1,273.04	Professional	AA	$334.90	$1,273.04	$1,273.04
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $160.72 / $184.32 / $401.80	Professional	QZ	$160.72	$184.32	$401.80
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