Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $954.99 / $2,570.40 / $4,365.16	Professional	AA	$954.99	$2,570.40	$4,365.16
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $346.74 / $812.83 / $1,905.46	Professional	QZ	$346.74	$812.83	$1,905.46
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $977.24 / $1,380.38 / $1,995.26	Professional	AA	$977.24	$1,380.38	$1,995.26
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $302.00 / $851.14 / $3,019.95	Professional	QZ	$302.00	$851.14	$3,019.95
Lucent Health Facility/Professional Facility Modifier QK Low / Median / High Price $52.48 / $52.48 / $52.48	Facility	QK	$52.48	$52.48	$52.48
Lucent Health Facility/Professional Facility Modifier QX Low / Median / High Price $52.48 / $52.48 / $52.48	Facility	QX	$52.48	$52.48	$52.48
Lucent Health Facility/Professional Facility Modifier QY Low / Median / High Price $52.48 / $52.48 / $52.48	Facility	QY	$52.48	$52.48	$52.48
Moda Health Facility/Professional Professional Modifier AA Low / Median / High Price $776.25 / $2,630.27 / $4,466.84	Professional	AA	$776.25	$2,630.27	$4,466.84
Moda Health Facility/Professional Professional Modifier QZ Low / Median / High Price $691.83 / $1,096.48 / $1,905.46	Professional	QZ	$691.83	$1,096.48	$1,905.46
Providence Facility/Professional Facility Modifier QK Low / Median / High Price $30.90 / $30.90 / $30.90	Facility	QK	$30.90	$30.90	$30.90
Providence Facility/Professional Facility Modifier QX Low / Median / High Price $30.90 / $30.90 / $30.90	Facility	QX	$30.90	$30.90	$30.90
Providence Facility/Professional Facility Modifier QY Low / Median / High Price $30.90 / $30.90 / $30.90	Facility	QY	$30.90	$30.90	$30.90