Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier QZ Low / Median / High Price $1,737.80 / $1,737.80 / $1,737.80	Facility	QZ	$1,737.80	$1,737.80	$1,737.80
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $676.08 / $1,412.54 / $2,454.71	Professional	AA	$676.08	$1,412.54	$2,454.71
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $467.74 / $954.99 / $2,238.72	Professional	QZ	$467.74	$954.99	$2,238.72
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $117.49 / $218.78 / $562.34	Professional	AA	$117.49	$218.78	$562.34
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $162.18 / $257.04 / $512.86	Professional	QZ	$162.18	$257.04	$512.86
BCBS Facility/Professional Professional Modifier QZ Low / Median / High Price $97.72 / $218.78 / $288.40	Professional	QZ	$97.72	$218.78	$288.40
Health Alliance Plan Facility/Professional Professional Modifier AA Low / Median / High Price $630.96 / $1,348.96 / $2,454.71	Professional	AA	$630.96	$1,348.96	$2,454.71
Health Alliance Plan Facility/Professional Professional Modifier QZ Low / Median / High Price $371.54 / $912.01 / $1,698.24	Professional	QZ	$371.54	$912.01	$1,698.24