Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $433.50 / $867.00 / $1,254.59	Professional	AA	$433.50	$867.00	$1,254.59
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $148.91 / $722.50 / $1,083.75	Professional	QZ	$148.91	$722.50	$1,083.75
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $408.00 / $605.00 / $825.00	Professional	AA	$408.00	$605.00	$825.00
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $408.00 / $612.00 / $889.20	Professional	QZ	$408.00	$612.00	$889.20
Qualchoice Facility/Professional Professional Modifier AA Low / Median / High Price $586.50 / $695.75 / $948.75	Professional	AA	$586.50	$695.75	$948.75
Qualchoice Facility/Professional Professional Modifier QZ Low / Median / High Price $410.55 / $707.94 / $1,022.58	Professional	QZ	$410.55	$707.94	$1,022.58