Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier AA Low / Median / High Price $616.60 / $616.60 / $616.60	Facility	AA	$616.60	$616.60	$616.60
Aetna Facility/Professional Facility Modifier QK Low / Median / High Price $263.03 / $263.03 / $263.03	Facility	QK	$263.03	$263.03	$263.03
Aetna Facility/Professional Facility Modifier QX Low / Median / High Price $151.36 / $275.42 / $354.81	Facility	QX	$151.36	$275.42	$354.81
Aetna Facility/Professional Facility Modifier QZ Low / Median / High Price $1,230.27 / $1,230.27 / $1,288.25	Facility	QZ	$1,230.27	$1,230.27	$1,288.25
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $380.19 / $446.68 / $3,630.78	Professional	AA	$380.19	$446.68	$3,630.78
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $223.87 / $354.81 / $478.63	Professional	QX	$223.87	$354.81	$478.63
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $77.62 / $288.40 / $309.03	Professional	QY	$77.62	$288.40	$309.03
Martin's Point Facility/Professional Facility Modifier AA Low / Median / High Price $616.60 / $616.60 / $616.60	Facility	AA	$616.60	$616.60	$616.60
Martin's Point Facility/Professional Facility Modifier QK Low / Median / High Price $263.03 / $263.03 / $263.03	Facility	QK	$263.03	$263.03	$263.03
Martin's Point Facility/Professional Facility Modifier QX Low / Median / High Price $151.36 / $275.42 / $354.81	Facility	QX	$151.36	$275.42	$354.81
Martin's Point Facility/Professional Facility Modifier QZ Low / Median / High Price $1,230.27 / $1,230.27 / $1,288.25	Facility	QZ	$1,230.27	$1,230.27	$1,288.25
Martin's Point Facility/Professional Professional Modifier AA Low / Median / High Price $346.74 / $575.44 / $776.25	Professional	AA	$346.74	$575.44	$776.25
Martin's Point Facility/Professional Professional Modifier QX Low / Median / High Price $234.42 / $288.40 / $380.19	Professional	QX	$234.42	$288.40	$380.19
Martin's Point Facility/Professional Professional Modifier QY Low / Median / High Price $234.42 / $288.40 / $398.11	Professional	QY	$234.42	$288.40	$398.11
Martin's Point Facility/Professional Professional Modifier QZ Low / Median / High Price $125.89 / $380.19 / $575.44	Professional	QZ	$125.89	$380.19	$575.44