Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $540.00 / $544.14 / $1,592.74	Facility		$540.00	$544.14	$1,592.74
Aetna Facility/Professional Facility Modifier AA Low / Median / High Price $722.58 / $722.58 / $722.58	Facility	AA	$722.58	$722.58	$722.58
Aetna Facility/Professional Facility Modifier QZ Low / Median / High Price $843.13 / $859.72 / $967.19	Facility	QZ	$843.13	$859.72	$967.19
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $534.67 / $629.41 / $1,437.07	Professional	AA	$534.67	$629.41	$1,437.07
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $168.48 / $185.51 / $910.52	Professional	QZ	$168.48	$185.51	$910.52
Moda Health Facility/Professional Professional Modifier QX Low / Median / High Price $47.25 / $47.25 / $47.25	Professional	QX	$47.25	$47.25	$47.25
Providence Facility/Professional Professional Modifier QK Low / Median / High Price $174.00 / $216.00 / $247.56	Professional	QK	$174.00	$216.00	$247.56
Providence Facility/Professional Professional Modifier QX Low / Median / High Price $174.00 / $216.00 / $247.56	Professional	QX	$174.00	$216.00	$247.56
Providence Facility/Professional Professional Modifier QY Low / Median / High Price $174.00 / $216.00 / $247.56	Professional	QY	$174.00	$216.00	$247.56
United Facility/Professional Professional Modifier QX Low / Median / High Price $80.00 / $80.00 / $80.00	Professional	QX	$80.00	$80.00	$80.00