Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $726.80 / $1,233.90 / $1,960.00	Professional	AA	$726.80	$1,233.90	$1,960.00
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $620.25 / $620.25 / $620.25	Professional	QZ	$620.25	$620.25	$620.25
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $165.84 / $784.00 / $1,365.00	Professional	AA	$165.84	$784.00	$1,365.00
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $243.00 / $621.00 / $621.00	Professional	QZ	$243.00	$621.00	$621.00
Lucent Health Facility/Professional Facility Modifier QK Low / Median / High Price $37.00 / $37.00 / $39.50	Facility	QK	$37.00	$37.00	$39.50
Lucent Health Facility/Professional Facility Modifier QX Low / Median / High Price $37.00 / $37.00 / $39.50	Facility	QX	$37.00	$37.00	$39.50
Lucent Health Facility/Professional Facility Modifier QY Low / Median / High Price $37.00 / $37.00 / $39.50	Facility	QY	$37.00	$37.00	$39.50
Providence Facility/Professional Facility Modifier QK Low / Median / High Price $244.20 / $244.20 / $244.20	Facility	QK	$244.20	$244.20	$244.20
Providence Facility/Professional Facility Modifier QX Low / Median / High Price $244.20 / $244.20 / $244.20	Facility	QX	$244.20	$244.20	$244.20
Providence Facility/Professional Facility Modifier QY Low / Median / High Price $244.20 / $244.20 / $244.20	Facility	QY	$244.20	$244.20	$244.20