Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier QK Low / Median / High Price $112.20 / $112.20 / $112.20	Facility	QK	$112.20	$112.20	$112.20
Aetna Facility/Professional Facility Modifier QX Low / Median / High Price $263.03 / $263.03 / $316.23	Facility	QX	$263.03	$263.03	$316.23
Aetna Facility/Professional Facility Modifier QY Low / Median / High Price $95.50 / $95.50 / $95.50	Facility	QY	$95.50	$95.50	$95.50
Cigna Facility/Professional Facility Modifier QK Low / Median / High Price $30.90 / $30.90 / $30.90	Facility	QK	$30.90	$30.90	$30.90
Cigna Facility/Professional Facility Modifier QX Low / Median / High Price $30.90 / $30.90 / $30.90	Facility	QX	$30.90	$30.90	$30.90
Cigna Facility/Professional Facility Modifier QY Low / Median / High Price $30.90 / $30.90 / $30.90	Facility	QY	$30.90	$30.90	$30.90
Martin's Point Facility/Professional Facility Modifier QK Low / Median / High Price $112.20 / $112.20 / $112.20	Facility	QK	$112.20	$112.20	$112.20
Martin's Point Facility/Professional Facility Modifier QX Low / Median / High Price $263.03 / $263.03 / $316.23	Facility	QX	$263.03	$263.03	$316.23
Martin's Point Facility/Professional Facility Modifier QY Low / Median / High Price $95.50 / $95.50 / $95.50	Facility	QY	$95.50	$95.50	$95.50