Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $768.23 / $2,800.00 / $3,716.23	Professional	AA	$768.23	$2,800.00	$3,716.23
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $341.87 / $341.87 / $830.25	Professional	QZ	$341.87	$341.87	$830.25
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
Providence Facility/Professional Facility Modifier QK Low / Median / High Price $366.30 / $366.30 / $366.30	Facility	QK	$366.30	$366.30	$366.30
Providence Facility/Professional Facility Modifier QX Low / Median / High Price $366.30 / $366.30 / $366.30	Facility	QX	$366.30	$366.30	$366.30
Providence Facility/Professional Facility Modifier QY Low / Median / High Price $366.30 / $366.30 / $366.30	Facility	QY	$366.30	$366.30	$366.30