Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $30.20 / $323.59 / $371.54	Facility		$30.20	$323.59	$371.54
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $380.19 / $380.19 / $380.19	Professional	AA	$380.19	$380.19	$380.19
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $524.81 / $691.83 / $912.01	Professional	QX	$524.81	$691.83	$912.01
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $501.19 / $501.19 / $501.19	Professional	QZ	$501.19	$501.19	$501.19
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $64.57 / $64.57 / $144.54	Professional	QX	$64.57	$64.57	$144.54
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $104.71 / $125.89 / $323.59	Professional	QZ	$104.71	$125.89	$323.59
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $426.58 / $660.69	Professional		$151.36	$426.58	$660.69
Kaiser Permanente Facility/Professional Professional Modifier QK Low / Median / High Price $123.03 / $123.03 / $165.96	Professional	QK	$123.03	$123.03	$165.96
Kaiser Permanente Facility/Professional Professional Modifier QX Low / Median / High Price $123.03 / $123.03 / $165.96	Professional	QX	$123.03	$123.03	$165.96
Kaiser Permanente Facility/Professional Professional Modifier QY Low / Median / High Price $123.03 / $123.03 / $165.96	Professional	QY	$123.03	$123.03	$165.96