Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $630.69 / $1,286.92 / $2,100.00	Professional	AA	$630.69	$1,286.92	$2,100.00
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $546.00 / $854.50 / $1,674.00	Professional	AA	$546.00	$854.50	$1,674.00
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $120.30 / $120.30 / $120.30	Professional	QZ	$120.30	$120.30	$120.30
Lucent Health Facility/Professional Facility Modifier QK Low / Median / High Price $37.00 / $37.00 / $39.50	Facility	QK	$37.00	$37.00	$39.50
Lucent Health Facility/Professional Facility Modifier QX Low / Median / High Price $37.00 / $37.00 / $39.50	Facility	QX	$37.00	$37.00	$39.50
Lucent Health Facility/Professional Facility Modifier QY Low / Median / High Price $37.00 / $37.00 / $39.50	Facility	QY	$37.00	$37.00	$39.50
Providence Facility/Professional Facility Modifier QK Low / Median / High Price $244.20 / $244.20 / $244.20	Facility	QK	$244.20	$244.20	$244.20
Providence Facility/Professional Facility Modifier QX Low / Median / High Price $244.20 / $244.20 / $244.20	Facility	QX	$244.20	$244.20	$244.20
Providence Facility/Professional Facility Modifier QY Low / Median / High Price $244.20 / $244.20 / $244.20	Facility	QY	$244.20	$244.20	$244.20