Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $1,122.02 / $1,548.82 / $1,548.82	Professional	AA	$1,122.02	$1,548.82	$1,548.82
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $128.82 / $812.83 / $1,148.15	Professional	QZ	$128.82	$812.83	$1,148.15
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $251.19 / $251.19 / $251.19	Professional	AA	$251.19	$251.19	$251.19
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $199.53 / $275.42 / $407.38	Professional	QZ	$199.53	$275.42	$407.38
Medica Facility/Professional Facility Modifier QK Low / Median / High Price $39.81 / $39.81 / $39.81	Facility	QK	$39.81	$39.81	$39.81
Medica Facility/Professional Facility Modifier QX Low / Median / High Price $39.81 / $39.81 / $39.81	Facility	QX	$39.81	$39.81	$39.81
Medica Facility/Professional Facility Modifier QY Low / Median / High Price $39.81 / $39.81 / $39.81	Facility	QY	$39.81	$39.81	$39.81
Qualchoice Facility/Professional Professional Modifier QZ Low / Median / High Price $467.74 / $467.74 / $467.74	Professional	QZ	$467.74	$467.74	$467.74