Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $389.05 / $676.08 / $1,122.02	Professional	AA	$389.05	$676.08	$1,122.02
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $89.13 / $275.42 / $575.44	Professional	QZ	$89.13	$275.42	$575.44
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $104.71 / $123.03 / $162.18	Professional	AA	$104.71	$123.03	$162.18
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $100.00 / $199.53 / $436.52	Professional	QZ	$100.00	$199.53	$436.52
Lucent Health Facility/Professional Facility Modifier QK Low / Median / High Price $52.48 / $52.48 / $52.48	Facility	QK	$52.48	$52.48	$52.48
Lucent Health Facility/Professional Facility Modifier QX Low / Median / High Price $52.48 / $52.48 / $52.48	Facility	QX	$52.48	$52.48	$52.48
Lucent Health Facility/Professional Facility Modifier QY Low / Median / High Price $52.48 / $52.48 / $52.48	Facility	QY	$52.48	$52.48	$52.48