Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier AA Low / Median / High Price $616.60 / $616.60 / $954.99	Facility	AA	$616.60	$616.60	$954.99
Aetna Facility/Professional Facility Modifier QK Low / Median / High Price $257.04 / $389.05 / $954.99	Facility	QK	$257.04	$389.05	$954.99
Aetna Facility/Professional Facility Modifier QX Low / Median / High Price $707.95 / $933.25 / $2,691.53	Facility	QX	$707.95	$933.25	$2,691.53
Aetna Facility/Professional Facility Modifier QY Low / Median / High Price $263.03 / $263.03 / $363.08	Facility	QY	$263.03	$263.03	$363.08
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 $616.60 / $616.60 / $954.99	Facility	AA	$616.60	$616.60	$954.99
Martin's Point Facility/Professional Facility Modifier QK Low / Median / High Price $257.04 / $389.05 / $954.99	Facility	QK	$257.04	$389.05	$954.99
Martin's Point Facility/Professional Facility Modifier QX Low / Median / High Price $707.95 / $933.25 / $2,691.53	Facility	QX	$707.95	$933.25	$2,691.53
Martin's Point Facility/Professional Facility Modifier QY Low / Median / High Price $263.03 / $263.03 / $363.08	Facility	QY	$263.03	$263.03	$363.08