Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier QX Low / Median / High Price $812.83 / $1,096.48 / $1,548.82	Facility	QX	$812.83	$1,096.48	$1,548.82
Cigna Facility/Professional Facility Modifier QK Low / Median / High Price $30.90 / $30.90 / $30.90	Facility	QK	$30.90	$30.90	$30.90
Cigna Facility/Professional Facility Modifier QX Low / Median / High Price $30.90 / $30.90 / $30.90	Facility	QX	$30.90	$30.90	$30.90
Cigna Facility/Professional Facility Modifier QY Low / Median / High Price $30.90 / $30.90 / $30.90	Facility	QY	$30.90	$30.90	$30.90
Martin's Point Facility/Professional Facility Modifier QX Low / Median / High Price $812.83 / $1,096.48 / $1,548.82	Facility	QX	$812.83	$1,096.48	$1,548.82