Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $3,500.00 / $3,500.00 / $3,500.00	Professional	AA	$3,500.00	$3,500.00	$3,500.00
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 $651.20 / $651.20 / $651.20	Facility	QK	$651.20	$651.20	$651.20
Providence Facility/Professional Facility Modifier QX Low / Median / High Price $651.20 / $651.20 / $651.20	Facility	QX	$651.20	$651.20	$651.20
Providence Facility/Professional Facility Modifier QY Low / Median / High Price $651.20 / $651.20 / $651.20	Facility	QY	$651.20	$651.20	$651.20