Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier QZ Low / Median / High Price $1,662.50 / $1,662.50 / $1,781.25	Facility	QZ	$1,662.50	$1,662.50	$1,781.25
Providence Facility/Professional Facility Modifier QK Low / Median / High Price $284.89 / $284.89 / $284.89	Facility	QK	$284.89	$284.89	$284.89
Providence Facility/Professional Facility Modifier QX Low / Median / High Price $284.89 / $284.89 / $284.89	Facility	QX	$284.89	$284.89	$284.89
Providence Facility/Professional Facility Modifier QY Low / Median / High Price $284.89 / $284.89 / $284.89	Facility	QY	$284.89	$284.89	$284.89