Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $186.21 / $870.96 / $1,412.54	Professional	AA	$186.21	$870.96	$1,412.54
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $676.08 / $724.44 / $1,122.02	Professional	QZ	$676.08	$724.44	$1,122.02
Moda Health Facility/Professional Professional Modifier AA Low / Median / High Price $173.78 / $1,000.00 / $1,412.54	Professional	AA	$173.78	$1,000.00	$1,412.54
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