Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier AA Low / Median / High Price $9,928.68 / $9,928.68 / $9,928.68	Facility	AA	$9,928.68	$9,928.68	$9,928.68
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $564.40 / $980.00 / $1,820.00	Professional	AA	$564.40	$980.00	$1,820.00
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $348.39 / $348.39 / $348.39	Professional	QZ	$348.39	$348.39	$348.39
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $168.72 / $585.00 / $1,190.00	Professional	AA	$168.72	$585.00	$1,190.00
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $180.45 / $510.00 / $1,440.00	Professional	QZ	$180.45	$510.00	$1,440.00
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 $203.50 / $203.50 / $203.50	Facility	QK	$203.50	$203.50	$203.50
Providence Facility/Professional Facility Modifier QX Low / Median / High Price $203.50 / $203.50 / $203.50	Facility	QX	$203.50	$203.50	$203.50
Providence Facility/Professional Facility Modifier QY Low / Median / High Price $203.50 / $203.50 / $203.50	Facility	QY	$203.50	$203.50	$203.50
United Facility/Professional Professional Modifier AA Low / Median / High Price $88.00 / $88.00 / $88.00	Professional	AA	$88.00	$88.00	$88.00