Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $1,120.00 / $1,540.00 / $1,540.00	Professional	AA	$1,120.00	$1,540.00	$1,540.00
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $228.94 / $228.94 / $424.58	Professional	QZ	$228.94	$228.94	$424.58
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $327.68 / $450.00 / $450.00	Professional	AA	$327.68	$450.00	$450.00
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $510.00 / $510.00 / $510.00	Professional	QZ	$510.00	$510.00	$510.00
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 $469.20 / $469.20 / $586.50	Professional	QZ	$469.20	$469.20	$586.50