Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier AA Low / Median / High Price $3,715.35 / $3,715.35 / $3,715.35	Facility	AA	$3,715.35	$3,715.35	$3,715.35
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $446.68 / $977.24 / $2,089.30	Professional	AA	$446.68	$977.24	$2,089.30
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $125.89 / $389.05 / $794.33	Professional	AA	$125.89	$389.05	$794.33
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 Facility Modifier AA Low / Median / High Price $3,715.35 / $3,715.35 / $3,715.35	Facility	AA	$3,715.35	$3,715.35	$3,715.35
Moda Health Facility/Professional Professional Modifier AA Low / Median / High Price $446.68 / $912.01 / $2,137.96	Professional	AA	$446.68	$912.01	$2,137.96
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