Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier AA Low / Median / High Price $611.10 / $611.10 / $702.75	Facility	AA	$611.10	$611.10	$702.75
Aetna Facility/Professional Facility Modifier QK Low / Median / High Price $597.60 / $597.60 / $672.30	Facility	QK	$597.60	$597.60	$672.30
Aetna Facility/Professional Facility Modifier QX Low / Median / High Price $228.21 / $651.23 / $651.23	Facility	QX	$228.21	$651.23	$651.23
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $403.00 / $403.00 / $403.00	Professional	AA	$403.00	$403.00	$403.00
Martin's Point Facility/Professional Facility Modifier AA Low / Median / High Price $611.10 / $611.10 / $702.75	Facility	AA	$611.10	$611.10	$702.75
Martin's Point Facility/Professional Facility Modifier QK Low / Median / High Price $597.60 / $597.60 / $672.30	Facility	QK	$597.60	$597.60	$672.30
Martin's Point Facility/Professional Facility Modifier QX Low / Median / High Price $178.36 / $321.45 / $651.23	Facility	QX	$178.36	$321.45	$651.23
United Facility/Professional Professional Modifier QZ Low / Median / High Price $632.45 / $632.45 / $632.45	Professional	QZ	$632.45	$632.45	$632.45