Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $51.29 / $645.65 / $758.58	Facility		$51.29	$645.65	$758.58
Aetna Facility/Professional Facility Modifier AA Low / Median / High Price $616.60 / $630.96 / $1,096.48	Facility	AA	$616.60	$630.96	$1,096.48
Aetna Facility/Professional Facility Modifier QK Low / Median / High Price $275.42 / $446.68 / $602.56	Facility	QK	$275.42	$446.68	$602.56
Aetna Facility/Professional Facility Modifier QX Low / Median / High Price $9.12 / $275.42 / $724.44	Facility	QX	$9.12	$275.42	$724.44
Aetna Facility/Professional Facility Modifier QY Low / Median / High Price $263.03 / $263.03 / $263.03	Facility	QY	$263.03	$263.03	$263.03
Aetna Facility/Professional Facility Modifier QZ Low / Median / High Price $741.31 / $1,288.25 / $1,479.11	Facility	QZ	$741.31	$1,288.25	$1,479.11
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $380.19 / $616.60 / $831.76	Professional	AA	$380.19	$616.60	$831.76
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $245.47 / $354.81 / $776.25	Professional	QK	$245.47	$354.81	$776.25
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $251.19 / $354.81 / $741.31	Professional	QX	$251.19	$354.81	$741.31
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $281.84 / $549.54 / $776.25	Professional	QY	$281.84	$549.54	$776.25
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $416.87 / $588.84 / $691.83	Professional	QZ	$416.87	$588.84	$691.83
Community Health Options Facility/Professional Facility Modifier Low / Median / High Price $2,041.74 / $2,041.74 / $2,041.74	Facility		$2,041.74	$2,041.74	$2,041.74
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $51.29 / $645.65 / $758.58	Facility		$51.29	$645.65	$758.58
Martin's Point Facility/Professional Facility Modifier AA Low / Median / High Price $616.60 / $630.96 / $1,096.48	Facility	AA	$616.60	$630.96	$1,096.48
Martin's Point Facility/Professional Facility Modifier QK Low / Median / High Price $275.42 / $446.68 / $602.56	Facility	QK	$275.42	$446.68	$602.56
Martin's Point Facility/Professional Facility Modifier QX Low / Median / High Price $9.12 / $275.42 / $724.44	Facility	QX	$9.12	$275.42	$724.44
Martin's Point Facility/Professional Facility Modifier QY Low / Median / High Price $263.03 / $263.03 / $263.03	Facility	QY	$263.03	$263.03	$263.03
Martin's Point Facility/Professional Facility Modifier QZ Low / Median / High Price $77.62 / $794.33 / $1,479.11	Facility	QZ	$77.62	$794.33	$1,479.11
Martin's Point Facility/Professional Professional Modifier AA Low / Median / High Price $363.08 / $616.60 / $851.14	Professional	AA	$363.08	$616.60	$851.14
Martin's Point Facility/Professional Professional Modifier QK Low / Median / High Price $213.80 / $288.40 / $549.54	Professional	QK	$213.80	$288.40	$549.54
Martin's Point Facility/Professional Professional Modifier QX Low / Median / High Price $229.09 / $302.00 / $489.78	Professional	QX	$229.09	$302.00	$489.78
Martin's Point Facility/Professional Professional Modifier QY Low / Median / High Price $234.42 / $288.40 / $691.83	Professional	QY	$234.42	$288.40	$691.83
Martin's Point Facility/Professional Professional Modifier QZ Low / Median / High Price $346.74 / $537.03 / $707.95	Professional	QZ	$346.74	$537.03	$707.95