Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $660.69 / $1,318.26 / $2,238.72	Professional	AA	$660.69	$1,318.26	$2,238.72
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $177.83 / $1,412.54 / $2,187.76	Professional	QZ	$177.83	$1,412.54	$2,187.76
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $645.65 / $645.65 / $912.01	Professional	AA	$645.65	$645.65	$912.01
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $194.98 / $263.03 / $1,047.13	Professional	QZ	$194.98	$263.03	$1,047.13
Lucent Health Facility/Professional Facility Modifier QK Low / Median / High Price $52.48 / $52.48 / $52.48	Facility	QK	$52.48	$52.48	$52.48
Lucent Health Facility/Professional Facility Modifier QX Low / Median / High Price $52.48 / $52.48 / $52.48	Facility	QX	$52.48	$52.48	$52.48
Lucent Health Facility/Professional Facility Modifier QY Low / Median / High Price $52.48 / $52.48 / $52.48	Facility	QY	$52.48	$52.48	$52.48
Moda Health Facility/Professional Professional Modifier AA Low / Median / High Price $436.52 / $1,000.00 / $2,187.76	Professional	AA	$436.52	$1,000.00	$2,187.76
Moda Health Facility/Professional Professional Modifier QZ Low / Median / High Price $177.83 / $831.76 / $1,778.28	Professional	QZ	$177.83	$831.76	$1,778.28
Providence Facility/Professional Facility Modifier QK Low / Median / High Price $30.90 / $30.90 / $30.90	Facility	QK	$30.90	$30.90	$30.90
Providence Facility/Professional Facility Modifier QX Low / Median / High Price $30.90 / $30.90 / $30.90	Facility	QX	$30.90	$30.90	$30.90
Providence Facility/Professional Facility Modifier QY Low / Median / High Price $30.90 / $30.90 / $30.90	Facility	QY	$30.90	$30.90	$30.90