Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier QK Low / Median / High Price $691.83 / $691.83 / $812.83	Facility	QK	$691.83	$691.83	$812.83
Aetna Facility/Professional Facility Modifier QX Low / Median / High Price $1,548.82 / $2,691.53 / $5,128.61	Facility	QX	$1,548.82	$2,691.53	$5,128.61
Aetna Facility/Professional Facility Modifier QY Low / Median / High Price $1,096.48 / $1,096.48 / $1,096.48	Facility	QY	$1,096.48	$1,096.48	$1,096.48
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 $691.83 / $691.83 / $812.83	Facility	QK	$691.83	$691.83	$812.83
Martin's Point Facility/Professional Facility Modifier QX Low / Median / High Price $1,548.82 / $2,691.53 / $5,128.61	Facility	QX	$1,548.82	$2,691.53	$5,128.61
Martin's Point Facility/Professional Facility Modifier QY Low / Median / High Price $1,096.48 / $1,096.48 / $1,096.48	Facility	QY	$1,096.48	$1,096.48	$1,096.48