Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $1,033.50 / $1,033.50 / $1,033.50	Professional	QX	$1,033.50	$1,033.50	$1,033.50
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $440.00 / $440.00 / $440.00	Professional	AA	$440.00	$440.00	$440.00
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $350.00 / $350.00 / $350.00	Professional	QZ	$350.00	$350.00	$350.00
Medica Facility/Professional Facility Modifier QK Low / Median / High Price $39.50 / $39.50 / $52.00	Facility	QK	$39.50	$39.50	$52.00
Medica Facility/Professional Facility Modifier QX Low / Median / High Price $39.50 / $39.50 / $52.00	Facility	QX	$39.50	$39.50	$52.00
Medica Facility/Professional Facility Modifier QY Low / Median / High Price $39.50 / $39.50 / $52.00	Facility	QY	$39.50	$39.50	$52.00