Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $1,680.00 / $1,680.00 / $1,680.00	Professional	AA	$1,680.00	$1,680.00	$1,680.00
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $577.50 / $577.50 / $577.50	Professional	QZ	$577.50	$577.50	$577.50
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $706.50 / $706.50 / $706.50	Professional	AA	$706.50	$706.50	$706.50
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $325.00 / $390.00 / $390.00	Professional	QZ	$325.00	$390.00	$390.00
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 $203.50 / $203.50 / $203.50	Facility	QK	$203.50	$203.50	$203.50
Providence Facility/Professional Facility Modifier QX Low / Median / High Price $203.50 / $203.50 / $203.50	Facility	QX	$203.50	$203.50	$203.50
Providence Facility/Professional Facility Modifier QY Low / Median / High Price $203.50 / $203.50 / $203.50	Facility	QY	$203.50	$203.50	$203.50