Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $1,659.59 / $2,344.23 / $2,818.38	Professional	AA	$1,659.59	$2,344.23	$2,818.38
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $977.24 / $977.24 / $977.24	Professional	QZ	$977.24	$977.24	$977.24
Moda Health Facility/Professional Professional Modifier AA Low / Median / High Price $1,659.59 / $2,344.23 / $2,818.38	Professional	AA	$1,659.59	$2,344.23	$2,818.38
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