Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $204.17 / $204.17 / $1,230.27	Professional	AA	$204.17	$204.17	$1,230.27
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $676.08 / $676.08 / $676.08	Professional	QZ	$676.08	$676.08	$676.08
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $186.21 / $218.78 / $524.81	Professional	QZ	$186.21	$218.78	$524.81
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