Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $309.03 / $2,884.03	Facility		$41.69	$309.03	$2,884.03
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $776.25 / $1,445.44 / $2,398.83	Professional	AA	$776.25	$1,445.44	$2,398.83
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $295.12 / $549.54 / $851.14	Professional	QK	$295.12	$549.54	$851.14
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $338.84 / $549.54 / $831.76	Professional	QX	$338.84	$549.54	$831.76
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $165.96 / $2,089.30 / $3,090.30	Professional	QZ	$165.96	$2,089.30	$3,090.30
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $199.53 / $363.08 / $1,258.93	Professional	AA	$199.53	$363.08	$1,258.93
Ambetter Facility/Professional Professional Modifier QK Low / Median / High Price $97.72 / $389.05 / $630.96	Professional	QK	$97.72	$389.05	$630.96
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $107.15 / $363.08 / $758.58	Professional	QX	$107.15	$363.08	$758.58
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $213.80 / $562.34 / $1,288.25	Professional	QZ	$213.80	$562.34	$1,288.25
BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,162.28 / $3,548.13 / $4,265.80	Facility		$3,162.28	$3,548.13	$4,265.80
Christus Facility/Professional Facility Modifier Low / Median / High Price $39.81 / $91.20 / $91.20	Facility		$39.81	$91.20	$91.20
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $104.71 / $104.71	Facility		$104.71	$104.71	$104.71
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 Facility Modifier Low / Median / High Price $42.66 / $2,398.83 / $4,897.79	Facility		$42.66	$2,398.83	$4,897.79
Moda Health Facility/Professional Professional Modifier AA Low / Median / High Price $691.83 / $1,348.96 / $2,344.23	Professional	AA	$691.83	$1,348.96	$2,344.23
Moda Health Facility/Professional Professional Modifier QK Low / Median / High Price $104.71 / $524.81 / $851.14	Professional	QK	$104.71	$524.81	$851.14
Moda Health Facility/Professional Professional Modifier QX Low / Median / High Price $288.40 / $549.54 / $851.14	Professional	QX	$288.40	$549.54	$851.14
Moda Health Facility/Professional Professional Modifier QZ Low / Median / High Price $758.58 / $891.25 / $1,412.54	Professional	QZ	$758.58	$891.25	$1,412.54
Providence Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $2,570.40 / $5,888.44	Facility		$41.69	$2,570.40	$5,888.44
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