Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
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 $488.40 / $488.40 / $488.40	Facility	QK	$488.40	$488.40	$488.40
Providence Facility/Professional Facility Modifier QX Low / Median / High Price $488.40 / $488.40 / $488.40	Facility	QX	$488.40	$488.40	$488.40
Providence Facility/Professional Facility Modifier QY Low / Median / High Price $488.40 / $488.40 / $488.40	Facility	QY	$488.40	$488.40	$488.40