Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $436.52 / $660.69 / $1,258.93	Professional	AA	$436.52	$660.69	$1,258.93
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $436.52 / $630.96 / $831.76	Professional	QZ	$436.52	$630.96	$831.76
Moda Health Facility/Professional Professional Modifier AA Low / Median / High Price $489.78 / $794.33 / $1,584.89	Professional	AA	$489.78	$794.33	$1,584.89
Moda Health Facility/Professional Professional Modifier QZ Low / Median / High Price $208.93 / $588.84 / $1,479.11	Professional	QZ	$208.93	$588.84	$1,479.11
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