Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $695.20 / $695.20 / $695.20	Professional	QZ	$695.20	$695.20	$695.20
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $612.00 / $612.00 / $612.00	Professional	AA	$612.00	$612.00	$612.00
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $612.00 / $612.00 / $612.00	Professional	QZ	$612.00	$612.00	$612.00
Qualchoice Facility/Professional Professional Modifier AA Low / Median / High Price $703.80 / $703.80 / $703.80	Professional	AA	$703.80	$703.80	$703.80
Qualchoice Facility/Professional Professional Modifier QZ Low / Median / High Price $703.80 / $703.80 / $703.80	Professional	QZ	$703.80	$703.80	$703.80