Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $51.29 / $489.78 / $724.44	Facility		$51.29	$489.78	$724.44
Aetna Facility/Professional Facility Modifier AA Low / Median / High Price $467.74 / $741.31 / $741.31	Facility	AA	$467.74	$741.31	$741.31
Aetna Facility/Professional Facility Modifier QK Low / Median / High Price $234.42 / $234.42 / $602.56	Facility	QK	$234.42	$234.42	$602.56
Aetna Facility/Professional Facility Modifier QX Low / Median / High Price $85.11 / $181.97 / $354.81	Facility	QX	$85.11	$181.97	$354.81
Aetna Facility/Professional Facility Modifier QY Low / Median / High Price $263.03 / $263.03 / $263.03	Facility	QY	$263.03	$263.03	$263.03
Aetna Facility/Professional Facility Modifier QZ Low / Median / High Price $812.83 / $1,258.93 / $1,659.59	Facility	QZ	$812.83	$1,258.93	$1,659.59
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $501.19 / $676.08 / $2,290.87	Professional	AA	$501.19	$676.08	$2,290.87
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $263.03 / $436.52 / $870.96	Professional	QK	$263.03	$436.52	$870.96
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $295.12 / $446.68 / $933.25	Professional	QX	$295.12	$446.68	$933.25
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $288.40 / $616.60 / $1,659.59	Professional	QY	$288.40	$616.60	$1,659.59
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $158.49 / $630.96 / $794.33	Professional	QZ	$158.49	$630.96	$794.33
Community Health Options Facility/Professional Facility Modifier Low / Median / High Price $616.60 / $616.60 / $616.60	Facility		$616.60	$616.60	$616.60
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $51.29 / $489.78 / $691.83	Facility		$51.29	$489.78	$691.83
Martin's Point Facility/Professional Facility Modifier AA Low / Median / High Price $467.74 / $691.83 / $741.31	Facility	AA	$467.74	$691.83	$741.31
Martin's Point Facility/Professional Facility Modifier QK Low / Median / High Price $234.42 / $234.42 / $602.56	Facility	QK	$234.42	$234.42	$602.56
Martin's Point Facility/Professional Facility Modifier QX Low / Median / High Price $85.11 / $181.97 / $354.81	Facility	QX	$85.11	$181.97	$354.81
Martin's Point Facility/Professional Facility Modifier QY Low / Median / High Price $263.03 / $263.03 / $263.03	Facility	QY	$263.03	$263.03	$263.03
Martin's Point Facility/Professional Facility Modifier QZ Low / Median / High Price $741.31 / $1,096.48 / $1,659.59	Facility	QZ	$741.31	$1,096.48	$1,659.59
Martin's Point Facility/Professional Professional Modifier AA Low / Median / High Price $416.87 / $676.08 / $2,398.83	Professional	AA	$416.87	$676.08	$2,398.83
Martin's Point Facility/Professional Professional Modifier QK Low / Median / High Price $234.42 / $338.84 / $630.96	Professional	QK	$234.42	$338.84	$630.96
Martin's Point Facility/Professional Professional Modifier QX Low / Median / High Price $239.88 / $338.84 / $575.44	Professional	QX	$239.88	$338.84	$575.44
Martin's Point Facility/Professional Professional Modifier QY Low / Median / High Price $245.47 / $316.23 / $724.44	Professional	QY	$245.47	$316.23	$724.44
Martin's Point Facility/Professional Professional Modifier QZ Low / Median / High Price $302.00 / $549.54 / $691.83	Professional	QZ	$302.00	$549.54	$691.83