Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $2,406.94 / $3,054.98 / $3,780.00	Professional	AA	$2,406.94	$3,054.98	$3,780.00
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $969.00 / $969.00 / $969.00	Professional	QZ	$969.00	$969.00	$969.00
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 $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
United Facility/Professional Professional Modifier AA Low / Median / High Price $80.00 / $80.00 / $80.00	Professional	AA	$80.00	$80.00	$80.00
United Facility/Professional Professional Modifier QZ Low / Median / High Price $80.00 / $80.00 / $80.00	Professional	QZ	$80.00	$80.00	$80.00