Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $446.68 / $446.68 / $457.09	Facility		$446.68	$446.68	$457.09
Aetna Facility/Professional Facility Modifier QZ Low / Median / High Price $724.44 / $870.96 / $954.99	Facility	QZ	$724.44	$870.96	$954.99
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $501.19 / $660.69 / $741.31	Professional	AA	$501.19	$660.69	$741.31
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $524.81 / $1,230.27 / $1,412.54	Professional	QX	$524.81	$1,230.27	$1,412.54
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $524.81 / $524.81 / $1,412.54	Professional	QY	$524.81	$524.81	$1,412.54
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $302.00 / $1,174.90 / $1,621.81	Professional	QZ	$302.00	$1,174.90	$1,621.81
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $50.12 / $457.09	Facility		$50.12	$50.12	$457.09
Moda Health Facility/Professional Facility Modifier QZ Low / Median / High Price $724.44 / $870.96 / $954.99	Facility	QZ	$724.44	$870.96	$954.99
Moda Health Facility/Professional Professional Modifier AA Low / Median / High Price $501.19 / $645.65 / $812.83	Professional	AA	$501.19	$645.65	$812.83
Moda Health Facility/Professional Professional Modifier QK Low / Median / High Price $524.81 / $676.08 / $794.33	Professional	QK	$524.81	$676.08	$794.33
Moda Health Facility/Professional Professional Modifier QX Low / Median / High Price $549.54 / $630.96 / $831.76	Professional	QX	$549.54	$630.96	$831.76
Moda Health Facility/Professional Professional Modifier QY Low / Median / High Price $549.54 / $676.08 / $724.44	Professional	QY	$549.54	$676.08	$724.44
Moda Health Facility/Professional Professional Modifier QZ Low / Median / High Price $302.00 / $630.96 / $1,995.26	Professional	QZ	$302.00	$630.96	$1,995.26
Providence Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $3,311.31 / $5,128.61	Facility		$50.12	$3,311.31	$5,128.61