Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $1,778.28 / $2,454.71 / $3,090.30	Professional	AA	$1,778.28	$2,454.71	$3,090.30
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $239.88 / $537.03 / $1,380.38	Professional	AA	$239.88	$537.03	$1,380.38
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $263.03 / $457.09 / $2,089.30	Professional	QZ	$263.03	$457.09	$2,089.30
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
Moda Health Facility/Professional Professional Modifier AA Low / Median / High Price $1,778.28 / $2,454.71 / $3,090.30	Professional	AA	$1,778.28	$2,454.71	$3,090.30
Moda Health Facility/Professional Professional Modifier QZ Low / Median / High Price $602.56 / $602.56 / $602.56	Professional	QZ	$602.56	$602.56	$602.56
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
Providence Facility/Professional Facility Modifier QY Low / Median / High Price $30.90 / $30.90 / $30.90	Facility	QY	$30.90	$30.90	$30.90