Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $866.02 / $866.02 / $866.02	Professional	AA	$866.02	$866.02	$866.02
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $531.20 / $531.20 / $531.20	Professional	QZ	$531.20	$531.20	$531.20
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $111.43 / $111.43 / $111.43	Professional	QX	$111.43	$111.43	$111.43
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $210.87 / $210.87 / $306.00	Professional	QZ	$210.87	$210.87	$306.00
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 $159.47 / $159.47 / $351.90	Professional	QZ	$159.47	$159.47	$351.90