Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $3,801.89 / $3,801.89 / $3,801.89	Professional	AA	$3,801.89	$3,801.89	$3,801.89
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $1,548.82 / $1,548.82 / $1,548.82	Professional	QZ	$1,548.82	$1,548.82	$1,548.82
Moda Health Facility/Professional Professional Modifier AA Low / Median / High Price $2,884.03 / $2,884.03 / $3,801.89	Professional	AA	$2,884.03	$2,884.03	$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