Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Lucent Health Facility/Professional Facility Modifier QK Low / Median / High Price $112.20 / $112.20 / $112.20	Facility	QK	$112.20	$112.20	$112.20
Lucent Health Facility/Professional Facility Modifier QX Low / Median / High Price $112.20 / $112.20 / $112.20	Facility	QX	$112.20	$112.20	$112.20
Lucent Health Facility/Professional Facility Modifier QY Low / Median / High Price $112.20 / $112.20 / $112.20	Facility	QY	$112.20	$112.20	$112.20
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