Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $302.51 / $391.60 / $627.94	Professional	QX	$302.51	$391.60	$627.94
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $392.70 / $392.70 / $392.70	Professional	QZ	$392.70	$392.70	$392.70
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $155.59 / $155.59 / $155.59	Professional	QX	$155.59	$155.59	$155.59
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $120.54 / $140.63 / $198.10	Professional	QZ	$120.54	$140.63	$198.10
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