Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier QZ Low / Median / High Price $300.00 / $300.00 / $300.00	Facility	QZ	$300.00	$300.00	$300.00
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $120.36 / $120.36 / $120.36	Professional	AA	$120.36	$120.36	$120.36
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $158.32 / $212.63 / $212.63	Professional	QZ	$158.32	$212.63	$212.63
BCBS Facility/Professional Professional Modifier QZ Low / Median / High Price $147.91 / $338.39 / $384.20	Professional	QZ	$147.91	$338.39	$384.20
Health Alliance Plan Facility/Professional Facility Modifier QZ Low / Median / High Price $300.00 / $300.00 / $300.00	Facility	QZ	$300.00	$300.00	$300.00