Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $622.50 / $1,400.00 / $2,128.37	Professional	AA	$622.50	$1,400.00	$2,128.37
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $833.04 / $833.04 / $912.29	Professional	QZ	$833.04	$833.04	$912.29
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $650.00 / $1,088.00 / $2,245.23	Professional	AA	$650.00	$1,088.00	$2,245.23
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $220.55 / $1,008.00 / $1,008.00	Professional	QZ	$220.55	$1,008.00	$1,008.00
Lucent Health Facility/Professional Facility Modifier QK Low / Median / High Price $37.00 / $37.00 / $39.50	Facility	QK	$37.00	$37.00	$39.50
Lucent Health Facility/Professional Facility Modifier QX Low / Median / High Price $37.00 / $37.00 / $39.50	Facility	QX	$37.00	$37.00	$39.50
Lucent Health Facility/Professional Facility Modifier QY Low / Median / High Price $37.00 / $37.00 / $39.50	Facility	QY	$37.00	$37.00	$39.50
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