Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $1,540.00 / $1,820.00 / $2,520.00	Professional	AA	$1,540.00	$1,820.00	$2,520.00
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $179.16 / $987.00 / $987.00	Professional	QZ	$179.16	$987.00	$987.00
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $281.26 / $281.26 / $281.26	Professional	AA	$281.26	$281.26	$281.26
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $253.63 / $308.39 / $445.47	Professional	QZ	$253.63	$308.39	$445.47
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