Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $204.17 / $870.96 / $2,754.23	Professional	AA	$204.17	$870.96	$2,754.23
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $467.74 / $891.25 / $977.24	Professional	QZ	$467.74	$891.25	$977.24
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $239.88 / $239.88 / $1,000.00	Professional	AA	$239.88	$239.88	$1,000.00
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $199.53 / $199.53 / $199.53	Professional	QZ	$199.53	$199.53	$199.53
Medica Facility/Professional Facility Modifier QK Low / Median / High Price $39.81 / $39.81 / $39.81	Facility	QK	$39.81	$39.81	$39.81
Medica Facility/Professional Facility Modifier QX Low / Median / High Price $39.81 / $39.81 / $39.81	Facility	QX	$39.81	$39.81	$39.81
Medica Facility/Professional Facility Modifier QY Low / Median / High Price $39.81 / $39.81 / $39.81	Facility	QY	$39.81	$39.81	$39.81