Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $145.11 / $145.11 / $145.11	Professional	AA	$145.11	$145.11	$145.11
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $51.83 / $333.20 / $333.20	Professional	QX	$51.83	$333.20	$333.20
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $360.00 / $360.00 / $360.00	Professional	QZ	$360.00	$360.00	$360.00
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 $203.50 / $203.50 / $203.50	Facility	QK	$203.50	$203.50	$203.50
Providence Facility/Professional Facility Modifier QX Low / Median / High Price $203.50 / $203.50 / $203.50	Facility	QX	$203.50	$203.50	$203.50
Providence Facility/Professional Facility Modifier QY Low / Median / High Price $203.50 / $203.50 / $203.50	Facility	QY	$203.50	$203.50	$203.50
Providence Facility/Professional Professional Modifier QX Low / Median / High Price $145.00 / $181.00 / $206.30	Professional	QX	$145.00	$181.00	$206.30
Providence Facility/Professional Professional Modifier QY Low / Median / High Price $145.00 / $181.00 / $206.30	Professional	QY	$145.00	$181.00	$206.30