Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier AA Low / Median / High Price $794.33 / $794.33 / $870.96	Facility	AA	$794.33	$794.33	$870.96
Aetna Facility/Professional Facility Modifier QK Low / Median / High Price $676.08 / $676.08 / $741.31	Facility	QK	$676.08	$676.08	$741.31
Aetna Facility/Professional Facility Modifier QX Low / Median / High Price $251.19 / $416.87 / $4,897.79	Facility	QX	$251.19	$416.87	$4,897.79
Aetna Facility/Professional Facility Modifier QY Low / Median / High Price $302.00 / $302.00 / $302.00	Facility	QY	$302.00	$302.00	$302.00
Aetna Facility/Professional Facility Modifier QZ Low / Median / High Price $1,202.26 / $1,258.93 / $1,584.89	Facility	QZ	$1,202.26	$1,258.93	$1,584.89
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $616.60 / $794.33 / $3,630.78	Professional	AA	$616.60	$794.33	$3,630.78
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $316.23 / $676.08 / $2,137.96	Professional	QK	$316.23	$676.08	$2,137.96
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $331.13 / $446.68 / $2,398.83	Professional	QX	$331.13	$446.68	$2,398.83
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $331.13 / $676.08 / $2,884.03	Professional	QY	$331.13	$676.08	$2,884.03
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $43.65 / $501.19 / $831.76	Professional	QZ	$43.65	$501.19	$831.76
Martin's Point Facility/Professional Facility Modifier AA Low / Median / High Price $794.33 / $794.33 / $870.96	Facility	AA	$794.33	$794.33	$870.96
Martin's Point Facility/Professional Facility Modifier QK Low / Median / High Price $676.08 / $676.08 / $741.31	Facility	QK	$676.08	$676.08	$741.31
Martin's Point Facility/Professional Facility Modifier QX Low / Median / High Price $251.19 / $416.87 / $4,897.79	Facility	QX	$251.19	$416.87	$4,897.79
Martin's Point Facility/Professional Facility Modifier QY Low / Median / High Price $302.00 / $302.00 / $302.00	Facility	QY	$302.00	$302.00	$302.00
Martin's Point Facility/Professional Facility Modifier QZ Low / Median / High Price $1,148.15 / $1,258.93 / $1,584.89	Facility	QZ	$1,148.15	$1,258.93	$1,584.89
Martin's Point Facility/Professional Professional Modifier AA Low / Median / High Price $588.84 / $794.33 / $3,801.89	Professional	AA	$588.84	$794.33	$3,801.89
Martin's Point Facility/Professional Professional Modifier QK Low / Median / High Price $281.84 / $354.81 / $794.33	Professional	QK	$281.84	$354.81	$794.33
Martin's Point Facility/Professional Professional Modifier QX Low / Median / High Price $281.84 / $363.08 / $724.44	Professional	QX	$281.84	$363.08	$724.44
Martin's Point Facility/Professional Professional Modifier QY Low / Median / High Price $288.40 / $346.74 / $2,818.38	Professional	QY	$288.40	$346.74	$2,818.38
Martin's Point Facility/Professional Professional Modifier QZ Low / Median / High Price $416.87 / $588.84 / $794.33	Professional	QZ	$416.87	$588.84	$794.33