Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier QZ Low / Median / High Price $1,725.30 / $1,725.30 / $1,725.30	Facility	QZ	$1,725.30	$1,725.30	$1,725.30
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $549.40 / $738.70 / $1,402.20	Professional	AA	$549.40	$738.70	$1,402.20
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $373.99 / $659.60 / $1,715.70	Professional	QZ	$373.99	$659.60	$1,715.70
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $273.38 / $315.86 / $1,188.00	Professional	AA	$273.38	$315.86	$1,188.00
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $121.50 / $177.19 / $350.96	Professional	QZ	$121.50	$177.19	$350.96
BCBS Facility/Professional Professional Modifier QZ Low / Median / High Price $110.94 / $216.75 / $288.14	Professional	QZ	$110.94	$216.75	$288.14
Health Alliance Plan Facility/Professional Professional Modifier AA Low / Median / High Price $549.40 / $972.84 / $1,402.20	Professional	AA	$549.40	$972.84	$1,402.20
Health Alliance Plan Facility/Professional Professional Modifier QZ Low / Median / High Price $373.99 / $659.60 / $1,715.70	Professional	QZ	$373.99	$659.60	$1,715.70