Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier AA Low / Median / High Price $4,488.00 / $4,488.00 / $4,488.00	Facility	AA	$4,488.00	$4,488.00	$4,488.00
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $537.20 / $687.30 / $1,400.00	Professional	AA	$537.20	$687.30	$1,400.00
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $140.35 / $650.00 / $1,200.00	Professional	AA	$140.35	$650.00	$1,200.00
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
United Facility/Professional Professional Modifier AA Low / Median / High Price $85.00 / $85.00 / $90.00	Professional	AA	$85.00	$85.00	$90.00