Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier QZ Low / Median / High Price $980.40 / $980.40 / $1,068.75	Facility	QZ	$980.40	$980.40	$1,068.75
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $627.20 / $1,120.00 / $1,820.00	Professional	AA	$627.20	$1,120.00	$1,820.00
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $1,157.09 / $1,157.09 / $1,157.09	Professional	QZ	$1,157.09	$1,157.09	$1,157.09
Providence Facility/Professional Facility Modifier QK Low / Median / High Price $244.20 / $244.20 / $244.20	Facility	QK	$244.20	$244.20	$244.20
Providence Facility/Professional Facility Modifier QX Low / Median / High Price $244.20 / $244.20 / $244.20	Facility	QX	$244.20	$244.20	$244.20
Providence Facility/Professional Facility Modifier QY Low / Median / High Price $244.20 / $244.20 / $244.20	Facility	QY	$244.20	$244.20	$244.20