Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,202.26 / $1,202.26 / $1,479.11	Facility		$1,202.26	$1,202.26	$1,479.11
Aetna Facility/Professional Facility Modifier QK Low / Median / High Price $891.25 / $891.25 / $891.25	Facility	QK	$891.25	$891.25	$891.25
Aetna Facility/Professional Facility Modifier QZ Low / Median / High Price $2,041.74 / $2,041.74 / $2,041.74	Facility	QZ	$2,041.74	$2,041.74	$2,041.74
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $812.83 / $1,000.00 / $4,570.88	Professional	AA	$812.83	$1,000.00	$4,570.88
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $416.87 / $1,659.59 / $3,630.78	Professional	QK	$416.87	$1,659.59	$3,630.78
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $354.81 / $524.81 / $3,630.78	Professional	QX	$354.81	$524.81	$3,630.78
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $1,230.27 / $1,230.27 / $1,230.27	Professional	QZ	$1,230.27	$1,230.27	$1,230.27
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $1,202.26 / $1,202.26 / $1,479.11	Facility		$1,202.26	$1,202.26	$1,479.11
Martin's Point Facility/Professional Facility Modifier QK Low / Median / High Price $891.25 / $891.25 / $891.25	Facility	QK	$891.25	$891.25	$891.25
Martin's Point Facility/Professional Facility Modifier QZ Low / Median / High Price $2,041.74 / $2,041.74 / $2,041.74	Facility	QZ	$2,041.74	$2,041.74	$2,041.74
Martin's Point Facility/Professional Professional Modifier AA Low / Median / High Price $831.76 / $1,412.54 / $4,786.30	Professional	AA	$831.76	$1,412.54	$4,786.30
Martin's Point Facility/Professional Professional Modifier QK Low / Median / High Price $95.50 / $398.11 / $1,819.70	Professional	QK	$95.50	$398.11	$1,819.70
Martin's Point Facility/Professional Professional Modifier QX Low / Median / High Price $316.23 / $489.78 / $776.25	Professional	QX	$316.23	$489.78	$776.25
Martin's Point Facility/Professional Professional Modifier QZ Low / Median / High Price $173.78 / $194.98 / $1,230.27	Professional	QZ	$173.78	$194.98	$1,230.27