Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $77.62 / $602.56 / $1,905.46	Professional	AA	$77.62	$602.56	$1,905.46
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $269.15 / $398.11 / $741.31	Professional	QX	$269.15	$398.11	$741.31
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $269.15 / $389.05 / $1,659.59	Professional	QY	$269.15	$389.05	$1,659.59
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $72.44 / $100.00 / $269.15	Professional	QZ	$72.44	$100.00	$269.15
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $79.43 / $79.43 / $549.54	Professional	AA	$79.43	$79.43	$549.54
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $257.04 / $257.04 / $323.59	Professional	QZ	$257.04	$257.04	$323.59
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 $120.23 / $120.23 / $120.23	Professional	QX	$120.23	$120.23	$120.23
Providence Facility/Professional Professional Modifier QY Low / Median / High Price $120.23 / $120.23 / $120.23	Professional	QY	$120.23	$120.23	$120.23