Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier QX Low / Median / High Price $2,344.23 / $2,344.23 / $2,344.23	Facility	QX	$2,344.23	$2,344.23	$2,344.23
Aetna Facility/Professional Facility Modifier QY Low / Median / High Price $831.76 / $831.76 / $831.76	Facility	QY	$831.76	$831.76	$831.76
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 QX Low / Median / High Price $2,344.23 / $2,344.23 / $2,344.23	Facility	QX	$2,344.23	$2,344.23	$2,344.23
Martin's Point Facility/Professional Facility Modifier QY Low / Median / High Price $831.76 / $831.76 / $831.76	Facility	QY	$831.76	$831.76	$831.76