Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $661.20 / $980.00 / $1,540.00	Professional	AA	$661.20	$980.00	$1,540.00
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $350.40 / $544.00 / $735.00	Professional	QZ	$350.40	$544.00	$735.00
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $160.72 / $589.52 / $855.00	Professional	AA	$160.72	$589.52	$855.00
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $122.88 / $160.72 / $700.00	Professional	QZ	$122.88	$160.72	$700.00
Lucent Health Facility/Professional Facility Modifier QK Low / Median / High Price $37.00 / $37.00 / $39.50	Facility	QK	$37.00	$37.00	$39.50
Lucent Health Facility/Professional Facility Modifier QX Low / Median / High Price $37.00 / $37.00 / $39.50	Facility	QX	$37.00	$37.00	$39.50
Lucent Health Facility/Professional Facility Modifier QY Low / Median / High Price $37.00 / $37.00 / $39.50	Facility	QY	$37.00	$37.00	$39.50
United Facility/Professional Professional Modifier QZ Low / Median / High Price $90.00 / $632.45 / $632.45	Professional	QZ	$90.00	$632.45	$632.45