Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $1,548.82 / $2,137.96 / $2,818.38	Professional	AA	$1,548.82	$2,137.96	$2,818.38
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $177.83 / $177.83 / $1,202.26	Professional	QZ	$177.83	$177.83	$1,202.26
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $263.03 / $776.25 / $1,047.13	Professional	AA	$263.03	$776.25	$1,047.13
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $281.84 / $758.58 / $1,288.25	Professional	QZ	$281.84	$758.58	$1,288.25
Lucent Health Facility/Professional Facility Modifier QK Low / Median / High Price $52.48 / $52.48 / $52.48	Facility	QK	$52.48	$52.48	$52.48
Lucent Health Facility/Professional Facility Modifier QX Low / Median / High Price $52.48 / $52.48 / $52.48	Facility	QX	$52.48	$52.48	$52.48
Lucent Health Facility/Professional Facility Modifier QY Low / Median / High Price $52.48 / $52.48 / $52.48	Facility	QY	$52.48	$52.48	$52.48
Moda Health Facility/Professional Professional Modifier AA Low / Median / High Price $1,174.90 / $1,949.84 / $2,691.53	Professional	AA	$1,174.90	$1,949.84	$2,691.53
Moda Health Facility/Professional Professional Modifier QZ Low / Median / High Price $177.83 / $741.31 / $1,202.26	Professional	QZ	$177.83	$741.31	$1,202.26
Providence Facility/Professional Facility Modifier QK Low / Median / High Price $30.90 / $30.90 / $30.90	Facility	QK	$30.90	$30.90	$30.90
Providence Facility/Professional Facility Modifier QX Low / Median / High Price $30.90 / $30.90 / $30.90	Facility	QX	$30.90	$30.90	$30.90
Providence Facility/Professional Facility Modifier QY Low / Median / High Price $30.90 / $30.90 / $30.90	Facility	QY	$30.90	$30.90	$30.90