Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $111.84 / $111.84 / $111.84	Facility		$111.84	$111.84	$111.84
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $39.18 / $554.40 / $1,661.88	Professional	AA	$39.18	$554.40	$1,661.88
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $956.94 / $956.94 / $956.94	Professional	QY	$956.94	$956.94	$956.94
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $126.13 / $383.50 / $717.60	Professional	QZ	$126.13	$383.50	$717.60
BCBS Facility/Professional Facility Modifier Low / Median / High Price $64,999.99 / $81,499.99 / $94,999.99	Facility		$64,999.99	$81,499.99	$94,999.99
Providence Facility/Professional Professional Modifier QK Low / Median / High Price $195.00 / $217.20 / $247.56	Professional	QK	$195.00	$217.20	$247.56
Providence Facility/Professional Professional Modifier QX Low / Median / High Price $195.00 / $217.20 / $247.56	Professional	QX	$195.00	$217.20	$247.56
Providence Facility/Professional Professional Modifier QY Low / Median / High Price $195.00 / $217.20 / $247.56	Professional	QY	$195.00	$217.20	$247.56
United Facility/Professional Professional Modifier AA Low / Median / High Price $75.00 / $75.00 / $75.00	Professional	AA	$75.00	$75.00	$75.00