Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier AA Low / Median / High Price $831.76 / $831.76 / $1,288.25	Facility	AA	$831.76	$831.76	$1,288.25
Aetna Facility/Professional Facility Modifier QK Low / Median / High Price $354.81 / $524.81 / $616.60	Facility	QK	$354.81	$524.81	$616.60
Aetna Facility/Professional Facility Modifier QX Low / Median / High Price $851.14 / $1,000.00 / $4,073.80	Facility	QX	$851.14	$1,000.00	$4,073.80
Aetna Facility/Professional Facility Modifier QY Low / Median / High Price $691.83 / $794.33 / $1,000.00	Facility	QY	$691.83	$794.33	$1,000.00
Cigna Facility/Professional Facility Modifier QK Low / Median / High Price $30.90 / $30.90 / $30.90	Facility	QK	$30.90	$30.90	$30.90
Cigna Facility/Professional Facility Modifier QX Low / Median / High Price $30.90 / $30.90 / $30.90	Facility	QX	$30.90	$30.90	$30.90
Cigna Facility/Professional Facility Modifier QY Low / Median / High Price $30.90 / $30.90 / $30.90	Facility	QY	$30.90	$30.90	$30.90
Martin's Point Facility/Professional Facility Modifier AA Low / Median / High Price $831.76 / $831.76 / $1,288.25	Facility	AA	$831.76	$831.76	$1,288.25
Martin's Point Facility/Professional Facility Modifier QK Low / Median / High Price $354.81 / $524.81 / $616.60	Facility	QK	$354.81	$524.81	$616.60
Martin's Point Facility/Professional Facility Modifier QX Low / Median / High Price $851.14 / $1,000.00 / $4,073.80	Facility	QX	$851.14	$1,000.00	$4,073.80
Martin's Point Facility/Professional Facility Modifier QY Low / Median / High Price $691.83 / $794.33 / $1,000.00	Facility	QY	$691.83	$794.33	$1,000.00