Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $504.50 / $504.50 / $504.50	Professional	QZ	$504.50	$504.50	$504.50
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $144.18 / $144.18 / $144.18	Professional	QX	$144.18	$144.18	$144.18
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $120.54 / $140.63 / $163.84	Professional	QZ	$120.54	$140.63	$163.84
Kaiser Permanente Facility/Professional Professional Modifier QK Low / Median / High Price $122.89 / $122.89 / $164.50	Professional	QK	$122.89	$122.89	$164.50
Kaiser Permanente Facility/Professional Professional Modifier QX Low / Median / High Price $122.89 / $122.89 / $164.50	Professional	QX	$122.89	$122.89	$164.50
Kaiser Permanente Facility/Professional Professional Modifier QY Low / Median / High Price $122.89 / $122.89 / $164.50	Professional	QY	$122.89	$122.89	$164.50