Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $630.69 / $1,400.00 / $2,100.00	Professional	AA	$630.69	$1,400.00	$2,100.00
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $180.45 / $180.45 / $585.00	Professional	AA	$180.45	$180.45	$585.00
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $120.30 / $880.00 / $975.00	Professional	QZ	$120.30	$880.00	$975.00
Lucent Health Facility/Professional Facility Modifier QK Low / Median / High Price $37.00 / $39.50 / $52.00	Facility	QK	$37.00	$39.50	$52.00
Lucent Health Facility/Professional Facility Modifier QX Low / Median / High Price $37.00 / $39.50 / $52.00	Facility	QX	$37.00	$39.50	$52.00
Lucent Health Facility/Professional Facility Modifier QY Low / Median / High Price $37.00 / $39.50 / $52.00	Facility	QY	$37.00	$39.50	$52.00
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