Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $602.56 / $660.69 / $741.31	Professional	AA	$602.56	$660.69	$741.31
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $295.12 / $389.05 / $660.69	Professional	QX	$295.12	$389.05	$660.69
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $416.87 / $416.87 / $416.87	Professional	QY	$416.87	$416.87	$416.87
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $100.00 / $354.81 / $1,348.96	Professional	QZ	$100.00	$354.81	$1,348.96
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $123.03 / $141.25 / $446.68	Professional	AA	$123.03	$141.25	$446.68
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $457.09 / $457.09 / $758.58	Professional	QX	$457.09	$457.09	$758.58
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $457.09 / $457.09 / $457.09	Professional	QZ	$457.09	$457.09	$457.09
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
Providence Facility/Professional Professional Modifier QX Low / Median / High Price $151.36 / $151.36 / $151.36	Professional	QX	$151.36	$151.36	$151.36
Providence Facility/Professional Professional Modifier QY Low / Median / High Price $151.36 / $151.36 / $151.36	Professional	QY	$151.36	$151.36	$151.36