Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $360.90 / $360.90 / $360.90	Professional	QZ	$360.90	$360.90	$360.90
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 $447.70 / $447.70 / $447.70	Facility	QK	$447.70	$447.70	$447.70
Providence Facility/Professional Facility Modifier QX Low / Median / High Price $447.70 / $447.70 / $447.70	Facility	QX	$447.70	$447.70	$447.70
Providence Facility/Professional Facility Modifier QY Low / Median / High Price $447.70 / $447.70 / $447.70	Facility	QY	$447.70	$447.70	$447.70