Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier QK Low / Median / High Price $489.78 / $489.78 / $489.78	Facility	QK	$489.78	$489.78	$489.78
Aetna Facility/Professional Facility Modifier QX Low / Median / High Price $1,348.96 / $1,348.96 / $1,348.96	Facility	QX	$1,348.96	$1,348.96	$1,348.96
Cigna Facility/Professional Facility Modifier QK Low / Median / High Price $30.90 / $30.90 / $30.90	Facility	QK	$30.90	$30.90	$30.90
Cigna Facility/Professional Facility Modifier QX Low / Median / High Price $30.90 / $30.90 / $30.90	Facility	QX	$30.90	$30.90	$30.90
Cigna Facility/Professional Facility Modifier QY Low / Median / High Price $30.90 / $30.90 / $30.90	Facility	QY	$30.90	$30.90	$30.90
Martin's Point Facility/Professional Facility Modifier QK Low / Median / High Price $489.78 / $489.78 / $489.78	Facility	QK	$489.78	$489.78	$489.78
Martin's Point Facility/Professional Facility Modifier QX Low / Median / High Price $1,348.96 / $1,348.96 / $1,348.96	Facility	QX	$1,348.96	$1,348.96	$1,348.96