Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $588.84 / $1,348.96 / $2,187.76	Professional	AA	$588.84	$1,348.96	$2,187.76
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $1,698.24 / $1,698.24 / $1,698.24	Professional	AA	$1,698.24	$1,698.24	$1,698.24
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
Moda Health Facility/Professional Professional Modifier AA Low / Median / High Price $398.11 / $776.25 / $2,187.76	Professional	AA	$398.11	$776.25	$2,187.76
Providence Facility/Professional Facility Modifier QK Low / Median / High Price $30.90 / $30.90 / $30.90	Facility	QK	$30.90	$30.90	$30.90
Providence Facility/Professional Facility Modifier QX Low / Median / High Price $30.90 / $30.90 / $30.90	Facility	QX	$30.90	$30.90	$30.90