Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $1,224.30 / $1,224.30 / $1,224.30	Professional	AA	$1,224.30	$1,224.30	$1,224.30
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $673.52 / $673.52 / $673.52	Professional	QZ	$673.52	$673.52	$673.52
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $160.72 / $327.68 / $327.68	Professional	AA	$160.72	$327.68	$327.68
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $160.72 / $184.32 / $241.08	Professional	QZ	$160.72	$184.32	$241.08
Kaiser Permanente Facility/Professional Professional Modifier QK Low / Median / High Price $147.47 / $147.47 / $197.40	Professional	QK	$147.47	$147.47	$197.40
Kaiser Permanente Facility/Professional Professional Modifier QX Low / Median / High Price $147.47 / $147.47 / $197.40	Professional	QX	$147.47	$147.47	$197.40
Kaiser Permanente Facility/Professional Professional Modifier QY Low / Median / High Price $147.47 / $147.47 / $197.40	Professional	QY	$147.47	$147.47	$197.40
United Facility/Professional Professional Modifier QZ Low / Median / High Price $70.00 / $70.00 / $70.00	Professional	QZ	$70.00	$70.00	$70.00