Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier QX Low / Median / High Price $812.83 / $812.83 / $812.83	Facility	QX	$812.83	$812.83	$812.83
Martin's Point Facility/Professional Facility Modifier QX Low / Median / High Price $812.83 / $812.83 / $812.83	Facility	QX	$812.83	$812.83	$812.83
Martin's Point Facility/Professional Professional Modifier QZ Low / Median / High Price $870.96 / $870.96 / $870.96	Professional	QZ	$870.96	$870.96	$870.96