Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $1,039.50 / $1,435.00 / $2,100.00	Professional	AA	$1,039.50	$1,435.00	$2,100.00
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $623.70 / $623.70 / $623.70	Professional	QZ	$623.70	$623.70	$623.70
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $845.00 / $1,360.00 / $2,800.00	Professional	AA	$845.00	$1,360.00	$2,800.00
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $258.57 / $800.00 / $1,040.00	Professional	QZ	$258.57	$800.00	$1,040.00
Lucent Health Facility/Professional Facility Modifier QK Low / Median / High Price $37.00 / $39.50 / $52.00	Facility	QK	$37.00	$39.50	$52.00
Lucent Health Facility/Professional Facility Modifier QX Low / Median / High Price $37.00 / $39.50 / $52.00	Facility	QX	$37.00	$39.50	$52.00
Lucent Health Facility/Professional Facility Modifier QY Low / Median / High Price $37.00 / $39.50 / $52.00	Facility	QY	$37.00	$39.50	$52.00
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