Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $691.83 / $1,174.90 / $1,698.24	Professional	AA	$691.83	$1,174.90	$1,698.24
Moda Health Facility/Professional Professional Modifier AA Low / Median / High Price $1,000.00 / $1,174.90 / $1,698.24	Professional	AA	$1,000.00	$1,174.90	$1,698.24
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