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 $529.10 / $529.10 / $529.10	Facility	QK	$529.10	$529.10	$529.10
Providence Facility/Professional Facility Modifier QX Low / Median / High Price $529.10 / $529.10 / $529.10	Facility	QX	$529.10	$529.10	$529.10
Providence Facility/Professional Facility Modifier QY Low / Median / High Price $529.10 / $529.10 / $529.10	Facility	QY	$529.10	$529.10	$529.10