Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier QK Low / Median / High Price $933.25 / $933.25 / $933.25	Facility	QK	$933.25	$933.25	$933.25
Aetna Facility/Professional Facility Modifier QX Low / Median / High Price $794.33 / $794.33 / $2,570.40	Facility	QX	$794.33	$794.33	$2,570.40
Aetna Facility/Professional Facility Modifier QY Low / Median / High Price $575.44 / $575.44 / $575.44	Facility	QY	$575.44	$575.44	$575.44
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 $933.25 / $933.25 / $933.25	Facility	QK	$933.25	$933.25	$933.25
Martin's Point Facility/Professional Facility Modifier QX Low / Median / High Price $794.33 / $794.33 / $2,570.40	Facility	QX	$794.33	$794.33	$2,570.40
Martin's Point Facility/Professional Facility Modifier QY Low / Median / High Price $575.44 / $575.44 / $575.44	Facility	QY	$575.44	$575.44	$575.44