Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $776.25 / $1,122.02 / $1,949.84	Professional	AA	$776.25	$1,122.02	$1,949.84
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $691.83 / $933.25 / $1,230.27	Professional	QZ	$691.83	$933.25	$1,230.27
Moda Health Facility/Professional Professional Modifier AA Low / Median / High Price $812.83 / $1,258.93 / $1,995.26	Professional	AA	$812.83	$1,258.93	$1,995.26
Moda Health Facility/Professional Professional Modifier QZ Low / Median / High Price $3,801.89 / $3,801.89 / $3,801.89	Professional	QZ	$3,801.89	$3,801.89	$3,801.89
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