Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $512.86 / $741.31 / $1,548.82	Professional	AA	$512.86	$741.31	$1,548.82
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $562.34 / $645.65 / $741.31	Professional	QZ	$562.34	$645.65	$741.31
Moda Health Facility/Professional Professional Modifier AA Low / Median / High Price $512.86 / $912.01 / $1,621.81	Professional	AA	$512.86	$912.01	$1,621.81
Moda Health Facility/Professional Professional Modifier QZ Low / Median / High Price $741.31 / $741.31 / $1,819.70	Professional	QZ	$741.31	$741.31	$1,819.70
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