Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier QZ Low / Median / High Price $977.24 / $1,071.52 / $1,071.52	Facility	QZ	$977.24	$1,071.52	$1,071.52
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $512.86 / $758.58 / $1,412.54	Professional	AA	$512.86	$758.58	$1,412.54
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $446.68 / $707.95 / $1,230.27	Professional	QZ	$446.68	$707.95	$1,230.27
Moda Health Facility/Professional Facility Modifier QZ Low / Median / High Price $977.24 / $977.24 / $1,071.52	Facility	QZ	$977.24	$977.24	$1,071.52
Moda Health Facility/Professional Professional Modifier AA Low / Median / High Price $602.56 / $954.99 / $1,698.24	Professional	AA	$602.56	$954.99	$1,698.24
Moda Health Facility/Professional Professional Modifier QZ Low / Median / High Price $660.69 / $1,202.26 / $2,344.23	Professional	QZ	$660.69	$1,202.26	$2,344.23
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