Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $812.83 / $2,089.30 / $2,884.03	Professional	AA	$812.83	$2,089.30	$2,884.03
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $467.74 / $1,445.44 / $1,548.82	Professional	QZ	$467.74	$1,445.44	$1,548.82
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $263.03 / $354.81 / $933.25	Professional	AA	$263.03	$354.81	$933.25
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $177.83 / $616.60 / $676.08	Professional	QZ	$177.83	$616.60	$676.08
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 $616.60 / $2,089.30 / $2,951.21	Professional	AA	$616.60	$2,089.30	$2,951.21
Moda Health Facility/Professional Professional Modifier QZ Low / Median / High Price $512.86 / $512.86 / $1,548.82	Professional	QZ	$512.86	$512.86	$1,548.82
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