Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $151.59 / $192.41 / $677.10	Facility		$151.59	$192.41	$677.10
Aetna Facility/Professional Facility Modifier AA Low / Median / High Price $152.13 / $527.05 / $747.00	Facility	AA	$152.13	$527.05	$747.00
Aetna Facility/Professional Facility Modifier QK Low / Median / High Price $236.79 / $236.79 / $597.60	Facility	QK	$236.79	$236.79	$597.60
Aetna Facility/Professional Facility Modifier QX Low / Median / High Price $84.89 / $97.02 / $236.79	Facility	QX	$84.89	$97.02	$236.79
Aetna Facility/Professional Facility Modifier QY Low / Median / High Price $261.45 / $261.45 / $261.45	Facility	QY	$261.45	$261.45	$261.45
Aetna Facility/Professional Facility Modifier QZ Low / Median / High Price $744.00 / $1,105.80 / $1,658.70	Facility	QZ	$744.00	$1,105.80	$1,658.70
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $39.18 / $39.18 / $39.18	Professional	AA	$39.18	$39.18	$39.18
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $126.13 / $126.13 / $717.60	Professional	QZ	$126.13	$126.13	$717.60
Community Health Options Facility/Professional Facility Modifier Low / Median / High Price $614.10 / $614.10 / $614.10	Facility		$614.10	$614.10	$614.10
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $50.90 / $473.97 / $691.63	Facility		$50.90	$473.97	$691.63
Martin's Point Facility/Professional Facility Modifier AA Low / Median / High Price $152.13 / $527.05 / $747.00	Facility	AA	$152.13	$527.05	$747.00
Martin's Point Facility/Professional Facility Modifier QK Low / Median / High Price $236.79 / $236.79 / $597.60	Facility	QK	$236.79	$236.79	$597.60
Martin's Point Facility/Professional Facility Modifier QX Low / Median / High Price $84.89 / $183.69 / $356.72	Facility	QX	$84.89	$183.69	$356.72
Martin's Point Facility/Professional Facility Modifier QY Low / Median / High Price $261.45 / $261.45 / $261.45	Facility	QY	$261.45	$261.45	$261.45
Martin's Point Facility/Professional Facility Modifier QZ Low / Median / High Price $744.00 / $1,105.80 / $1,658.70	Facility	QZ	$744.00	$1,105.80	$1,658.70
United Facility/Professional Professional Modifier AA Low / Median / High Price $1,445.60 / $1,445.60 / $1,445.60	Professional	AA	$1,445.60	$1,445.60	$1,445.60