Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier AA Low / Median / High Price $6,949.60 / $6,949.60 / $6,949.60	Facility	AA	$6,949.60	$6,949.60	$6,949.60
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $584.60 / $980.00 / $1,400.00	Professional	AA	$584.60	$980.00	$1,400.00
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $306.00 / $706.50 / $1,190.00	Professional	AA	$306.00	$706.50	$1,190.00
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $147.63 / $510.00 / $960.00	Professional	QZ	$147.63	$510.00	$960.00
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 $244.20 / $244.20 / $244.20	Facility	QK	$244.20	$244.20	$244.20
Providence Facility/Professional Facility Modifier QX Low / Median / High Price $244.20 / $244.20 / $244.20	Facility	QX	$244.20	$244.20	$244.20
Providence Facility/Professional Facility Modifier QY Low / Median / High Price $244.20 / $244.20 / $244.20	Facility	QY	$244.20	$244.20	$244.20