Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier AA Low / Median / High Price $6,949.60 / $6,949.60 / $6,949.60	Facility	AA	$6,949.60	$6,949.60	$6,949.60
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $359.10 / $700.00 / $1,680.00	Professional	AA	$359.10	$700.00	$1,680.00
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $295.47 / $403.20 / $403.20	Professional	QZ	$295.47	$403.20	$403.20
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $220.55 / $640.00 / $1,040.00	Professional	AA	$220.55	$640.00	$1,040.00
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $147.63 / $459.00 / $845.00	Professional	QZ	$147.63	$459.00	$845.00
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 $162.80 / $162.80 / $162.80	Facility	QK	$162.80	$162.80	$162.80
Providence Facility/Professional Facility Modifier QX Low / Median / High Price $162.80 / $162.80 / $162.80	Facility	QX	$162.80	$162.80	$162.80
Providence Facility/Professional Facility Modifier QY Low / Median / High Price $162.80 / $162.80 / $162.80	Facility	QY	$162.80	$162.80	$162.80