Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $253.57 / $1,156.00 / $1,300.50	Professional	QZ	$253.57	$1,156.00	$1,300.50
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $1,375.00 / $1,375.00 / $1,375.00	Professional	AA	$1,375.00	$1,375.00	$1,375.00
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $714.00 / $867.00 / $1,265.00	Professional	QZ	$714.00	$867.00	$1,265.00
Qualchoice Facility/Professional Professional Modifier AA Low / Median / High Price $1,348.95 / $1,348.95 / $1,581.25	Professional	AA	$1,348.95	$1,348.95	$1,581.25
Qualchoice Facility/Professional Professional Modifier QZ Low / Median / High Price $879.75 / $1,022.58 / $1,348.95	Professional	QZ	$879.75	$1,022.58	$1,348.95