Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $478.63 / $630.96 / $1,096.48	Professional	AA	$478.63	$630.96	$1,096.48
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $199.53 / $269.15 / $776.25	Professional	QZ	$199.53	$269.15	$776.25
Kaiser Permanente Facility/Professional Professional Modifier QK Low / Median / High Price $147.91 / $147.91 / $199.53	Professional	QK	$147.91	$147.91	$199.53
Kaiser Permanente Facility/Professional Professional Modifier QX Low / Median / High Price $147.91 / $147.91 / $199.53	Professional	QX	$147.91	$147.91	$199.53
Kaiser Permanente Facility/Professional Professional Modifier QY Low / Median / High Price $147.91 / $147.91 / $199.53	Professional	QY	$147.91	$147.91	$199.53