Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $416.87 / $891.25 / $1,513.56	Professional	AA	$416.87	$891.25	$1,513.56
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $602.56 / $851.14 / $1,122.02	Professional	QZ	$602.56	$851.14	$1,122.02
Moda Health Facility/Professional Professional Modifier AA Low / Median / High Price $199.53 / $1,047.13 / $1,659.59	Professional	AA	$199.53	$1,047.13	$1,659.59
Moda Health Facility/Professional Professional Modifier QZ Low / Median / High Price $602.56 / $831.76 / $2,238.72	Professional	QZ	$602.56	$831.76	$2,238.72
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