Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $980.00 / $980.00 / $1,076.14	Professional	AA	$980.00	$980.00	$1,076.14
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $286.64 / $286.64 / $286.64	Professional	QZ	$286.64	$286.64	$286.64
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $212.70 / $845.00 / $1,785.00	Professional	AA	$212.70	$845.00	$1,785.00
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $510.00 / $800.00 / $880.00	Professional	QZ	$510.00	$800.00	$880.00
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 $203.50 / $203.50 / $203.50	Facility	QK	$203.50	$203.50	$203.50
Providence Facility/Professional Facility Modifier QX Low / Median / High Price $203.50 / $203.50 / $203.50	Facility	QX	$203.50	$203.50	$203.50
Providence Facility/Professional Facility Modifier QY Low / Median / High Price $203.50 / $203.50 / $203.50	Facility	QY	$203.50	$203.50	$203.50