Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $729.80 / $1,411.88 / $2,261.25	Professional	AA	$729.80	$1,411.88	$2,261.25
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $758.16 / $758.16 / $758.16	Professional	QZ	$758.16	$758.16	$758.16
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $186.57 / $674.50 / $1,232.00	Professional	AA	$186.57	$674.50	$1,232.00
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $121.50 / $180.99 / $1,690.00	Professional	QZ	$121.50	$180.99	$1,690.00
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
Providence Facility/Professional Facility Modifier QK Low / Median / High Price $162.80 / $162.80 / $162.80	Facility	QK	$162.80	$162.80	$162.80
Providence Facility/Professional Facility Modifier QX Low / Median / High Price $162.80 / $162.80 / $162.80	Facility	QX	$162.80	$162.80	$162.80
Providence Facility/Professional Facility Modifier QY Low / Median / High Price $162.80 / $162.80 / $162.80	Facility	QY	$162.80	$162.80	$162.80