Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $267.00 / $363.52 / $496.86	Professional	QX	$267.00	$363.52	$496.86
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $267.00 / $267.00 / $389.60	Professional	QY	$267.00	$267.00	$389.60
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $80.36 / $80.36 / $742.60	Professional	AA	$80.36	$80.36	$742.60
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $90.11 / $90.11 / $428.55	Professional	QX	$90.11	$90.11	$428.55
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $80.36 / $100.45 / $140.63	Professional	QZ	$80.36	$100.45	$140.63
Kaiser Permanente Facility/Professional Professional Modifier QK Low / Median / High Price $98.31 / $98.31 / $131.60	Professional	QK	$98.31	$98.31	$131.60
Kaiser Permanente Facility/Professional Professional Modifier QX Low / Median / High Price $98.31 / $98.31 / $131.60	Professional	QX	$98.31	$98.31	$131.60
Kaiser Permanente Facility/Professional Professional Modifier QY Low / Median / High Price $98.31 / $98.31 / $131.60	Professional	QY	$98.31	$98.31	$131.60