Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $805.10 / $1,680.00 / $2,370.23	Professional	AA	$805.10	$1,680.00	$2,370.23
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $808.28 / $1,077.83 / $1,077.83	Professional	QX	$808.28	$1,077.83	$1,077.83
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $816.00 / $916.30 / $2,916.00	Professional	AA	$816.00	$916.30	$2,916.00
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $227.81 / $577.50 / $577.50	Professional	QX	$227.81	$577.50	$577.50
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $698.63 / $698.63 / $698.63	Professional	QZ	$698.63	$698.63	$698.63
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 $244.20 / $244.20 / $244.20	Facility	QK	$244.20	$244.20	$244.20
Providence Facility/Professional Facility Modifier QX Low / Median / High Price $244.20 / $244.20 / $244.20	Facility	QX	$244.20	$244.20	$244.20
Providence Facility/Professional Facility Modifier QY Low / Median / High Price $244.20 / $244.20 / $244.20	Facility	QY	$244.20	$244.20	$244.20
Providence Facility/Professional Professional Modifier QX Low / Median / High Price $174.00 / $216.00 / $247.56	Professional	QX	$174.00	$216.00	$247.56
Providence Facility/Professional Professional Modifier QY Low / Median / High Price $174.00 / $216.00 / $247.56	Professional	QY	$174.00	$216.00	$247.56