Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $711.45 / $1,258.32 / $1,820.00	Professional	AA	$711.45	$1,258.32	$1,820.00
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $712.95 / $712.95 / $712.95	Professional	QZ	$712.95	$712.95	$712.95
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $585.00 / $715.00 / $999.60	Professional	AA	$585.00	$715.00	$999.60
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $220.55 / $312.00 / $1,690.00	Professional	QZ	$220.55	$312.00	$1,690.00
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 $244.20 / $244.20 / $244.20	Facility	QK	$244.20	$244.20	$244.20
Providence Facility/Professional Facility Modifier QX Low / Median / High Price $244.20 / $244.20 / $244.20	Facility	QX	$244.20	$244.20	$244.20
Providence Facility/Professional Facility Modifier QY Low / Median / High Price $244.20 / $244.20 / $244.20	Facility	QY	$244.20	$244.20	$244.20