Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier AA Low / Median / High Price $527.05 / $611.10 / $614.90	Facility	AA	$527.05	$611.10	$614.90
Aetna Facility/Professional Facility Modifier QK Low / Median / High Price $261.45 / $261.45 / $261.45	Facility	QK	$261.45	$261.45	$261.45
Aetna Facility/Professional Facility Modifier QX Low / Median / High Price $147.77 / $203.10 / $356.72	Facility	QX	$147.77	$203.10	$356.72
Aetna Facility/Professional Facility Modifier QZ Low / Median / High Price $1,222.20 / $1,222.20 / $1,290.09	Facility	QZ	$1,222.20	$1,222.20	$1,290.09
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $127.22 / $127.22 / $127.22	Professional	AA	$127.22	$127.22	$127.22
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $114.41 / $114.41 / $344.50	Professional	QZ	$114.41	$114.41	$344.50
Martin's Point Facility/Professional Facility Modifier AA Low / Median / High Price $527.05 / $611.10 / $614.90	Facility	AA	$527.05	$611.10	$614.90
Martin's Point Facility/Professional Facility Modifier QK Low / Median / High Price $261.45 / $261.45 / $261.45	Facility	QK	$261.45	$261.45	$261.45
Martin's Point Facility/Professional Facility Modifier QX Low / Median / High Price $152.13 / $275.54 / $356.72	Facility	QX	$152.13	$275.54	$356.72
Martin's Point Facility/Professional Facility Modifier QZ Low / Median / High Price $1,222.20 / $1,222.20 / $1,290.09	Facility	QZ	$1,222.20	$1,222.20	$1,290.09