Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $549.54 / $562.34	Facility		$72.44	$549.54	$562.34
Aetna Facility/Professional Facility Modifier AA Low / Median / High Price $724.44 / $724.44 / $724.44	Facility	AA	$724.44	$724.44	$724.44
Aetna Facility/Professional Facility Modifier QZ Low / Median / High Price $851.14 / $851.14 / $977.24	Facility	QZ	$851.14	$851.14	$977.24
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $512.86 / $616.60 / $954.99	Professional	AA	$512.86	$616.60	$954.99
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $794.33 / $794.33 / $1,122.02	Professional	QK	$794.33	$794.33	$1,122.02
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $93.33 / $93.33 / $794.33	Professional	QX	$93.33	$93.33	$794.33
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $114.82 / $114.82 / $676.08	Professional	QY	$114.82	$114.82	$676.08
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $151.36 / $1,023.29 / $1,737.80	Professional	QZ	$151.36	$1,023.29	$1,737.80
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $537.03 / $1,584.89	Facility		$50.12	$537.03	$1,584.89
Moda Health Facility/Professional Facility Modifier AA Low / Median / High Price $724.44 / $724.44 / $724.44	Facility	AA	$724.44	$724.44	$724.44
Moda Health Facility/Professional Facility Modifier QZ Low / Median / High Price $851.14 / $851.14 / $977.24	Facility	QZ	$851.14	$851.14	$977.24
Moda Health Facility/Professional Professional Modifier AA Low / Median / High Price $512.86 / $645.65 / $831.76	Professional	AA	$512.86	$645.65	$831.76
Moda Health Facility/Professional Professional Modifier QK Low / Median / High Price $407.38 / $691.83 / $912.01	Professional	QK	$407.38	$691.83	$912.01
Moda Health Facility/Professional Professional Modifier QX Low / Median / High Price $575.44 / $724.44 / $912.01	Professional	QX	$575.44	$724.44	$912.01
Moda Health Facility/Professional Professional Modifier QY Low / Median / High Price $239.88 / $630.96 / $724.44	Professional	QY	$239.88	$630.96	$724.44
Moda Health Facility/Professional Professional Modifier QZ Low / Median / High Price $169.82 / $549.54 / $794.33	Professional	QZ	$169.82	$549.54	$794.33
Providence Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $3,311.31 / $5,128.61	Facility		$50.12	$3,311.31	$5,128.61