Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $1,820.00 / $2,367.28 / $2,940.00	Professional	AA	$1,820.00	$2,367.28	$2,940.00
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $1,011.75 / $1,368.00 / $2,332.40	Professional	AA	$1,011.75	$1,368.00	$2,332.40
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $425.25 / $425.25 / $425.25	Professional	QZ	$425.25	$425.25	$425.25
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 $366.30 / $366.30 / $366.30	Facility	QK	$366.30	$366.30	$366.30
Providence Facility/Professional Facility Modifier QX Low / Median / High Price $366.30 / $366.30 / $366.30	Facility	QX	$366.30	$366.30	$366.30
Providence Facility/Professional Facility Modifier QY Low / Median / High Price $366.30 / $366.30 / $366.30	Facility	QY	$366.30	$366.30	$366.30