Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier AA Low / Median / High Price $3,740.00 / $3,740.00 / $3,740.00	Facility	AA	$3,740.00	$3,740.00	$3,740.00
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $271.13 / $840.00 / $1,540.00	Professional	AA	$271.13	$840.00	$1,540.00
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $154.00 / $471.00 / $785.00	Professional	AA	$154.00	$471.00	$785.00
Lucent Health Facility/Professional Facility Modifier QK Low / Median / High Price $37.00 / $39.50 / $52.00	Facility	QK	$37.00	$39.50	$52.00
Lucent Health Facility/Professional Facility Modifier QX Low / Median / High Price $37.00 / $39.50 / $52.00	Facility	QX	$37.00	$39.50	$52.00
Lucent Health Facility/Professional Facility Modifier QY Low / Median / High Price $37.00 / $39.50 / $52.00	Facility	QY	$37.00	$39.50	$52.00
Providence Facility/Professional Facility Modifier QK Low / Median / High Price $162.80 / $162.80 / $162.80	Facility	QK	$162.80	$162.80	$162.80
Providence Facility/Professional Facility Modifier QX Low / Median / High Price $162.80 / $162.80 / $162.80	Facility	QX	$162.80	$162.80	$162.80
Providence Facility/Professional Facility Modifier QY Low / Median / High Price $162.80 / $162.80 / $162.80	Facility	QY	$162.80	$162.80	$162.80