Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier AA Low / Median / High Price $924.92 / $924.92 / $924.92	Facility	AA	$924.92	$924.92	$924.92
Lucent Health Facility/Professional Facility Modifier QK Low / Median / High Price $37.00 / $37.00 / $39.50	Facility	QK	$37.00	$37.00	$39.50
Lucent Health Facility/Professional Facility Modifier QX Low / Median / High Price $37.00 / $37.00 / $39.50	Facility	QX	$37.00	$37.00	$39.50
Lucent Health Facility/Professional Facility Modifier QY Low / Median / High Price $37.00 / $37.00 / $39.50	Facility	QY	$37.00	$37.00	$39.50
Providence Facility/Professional Facility Modifier QK Low / Median / High Price $284.89 / $284.89 / $284.89	Facility	QK	$284.89	$284.89	$284.89
Providence Facility/Professional Facility Modifier QX Low / Median / High Price $284.89 / $284.89 / $284.89	Facility	QX	$284.89	$284.89	$284.89
Providence Facility/Professional Facility Modifier QY Low / Median / High Price $284.89 / $284.89 / $284.89	Facility	QY	$284.89	$284.89	$284.89