Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $1,494.00 / $2,520.00 / $3,500.00	Professional	AA	$1,494.00	$2,520.00	$3,500.00
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $650.00 / $1,300.00 / $2,015.00	Professional	AA	$650.00	$1,300.00	$2,015.00
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $358.02 / $1,240.00 / $3,360.00	Professional	QZ	$358.02	$1,240.00	$3,360.00
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 $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