Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier QK Low / Median / High Price $851.14 / $851.14 / $1,000.00	Facility	QK	$851.14	$851.14	$1,000.00
Aetna Facility/Professional Facility Modifier QX Low / Median / High Price $1,862.09 / $1,862.09 / $4,677.35	Facility	QX	$1,862.09	$1,862.09	$4,677.35
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 QK Low / Median / High Price $851.14 / $851.14 / $1,000.00	Facility	QK	$851.14	$851.14	$1,000.00
Martin's Point Facility/Professional Facility Modifier QX Low / Median / High Price $1,862.09 / $1,862.09 / $4,677.35	Facility	QX	$1,862.09	$1,862.09	$4,677.35