Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier AA Low / Median / High Price $8,374.20 / $8,374.20 / $8,374.20	Facility	AA	$8,374.20	$8,374.20	$8,374.20
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $417.45 / $994.14 / $1,680.00	Professional	AA	$417.45	$994.14	$1,680.00
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $206.40 / $370.44 / $654.50	Professional	QZ	$206.40	$370.44	$654.50
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $260.64 / $715.00 / $1,272.00	Professional	AA	$260.64	$715.00	$1,272.00
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $200.50 / $706.50 / $1,280.00	Professional	QZ	$200.50	$706.50	$1,280.00
Lucent Health Facility/Professional Facility Modifier QK Low / Median / High Price $37.00 / $39.50 / $52.00	Facility	QK	$37.00	$39.50	$52.00
Lucent Health Facility/Professional Facility Modifier QX Low / Median / High Price $37.00 / $39.50 / $52.00	Facility	QX	$37.00	$39.50	$52.00
Lucent Health Facility/Professional Facility Modifier QY Low / Median / High Price $37.00 / $39.50 / $52.00	Facility	QY	$37.00	$39.50	$52.00
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