Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $1,147.53 / $1,680.00 / $2,520.00	Professional	AA	$1,147.53	$1,680.00	$2,520.00
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $561.00 / $1,416.10 / $2,210.00	Professional	AA	$561.00	$1,416.10	$2,210.00
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $1,020.00 / $1,020.00 / $1,020.00	Professional	QZ	$1,020.00	$1,020.00	$1,020.00
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 $284.89 / $284.89 / $284.89	Facility	QK	$284.89	$284.89	$284.89
Providence Facility/Professional Facility Modifier QX Low / Median / High Price $284.89 / $284.89 / $284.89	Facility	QX	$284.89	$284.89	$284.89
Providence Facility/Professional Facility Modifier QY Low / Median / High Price $284.89 / $284.89 / $284.89	Facility	QY	$284.89	$284.89	$284.89