Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $54.57 / $305.00 / $420.00	Facility		$54.57	$305.00	$420.00
Aetna Facility/Professional Facility Modifier QZ Low / Median / High Price $502.51 / $502.51 / $502.51	Facility	QZ	$502.51	$502.51	$502.51
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $48.00 / $470.40 / $1,120.00	Professional	AA	$48.00	$470.40	$1,120.00
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $138.32 / $138.32 / $138.32	Professional	QX	$138.32	$138.32	$138.32
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $330.60 / $520.00 / $598.00	Professional	QZ	$330.60	$520.00	$598.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $310.00 / $364.15 / $424.55	Professional		$310.00	$364.15	$424.55
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $19.95 / $4,845.79 / $5,085.88	Facility		$19.95	$4,845.79	$5,085.88
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $212.50 / $260.00 / $376.25	Facility		$212.50	$260.00	$376.25
Providence Facility/Professional Facility Modifier Low / Median / High Price $407.00 / $3,232.79 / $5,085.88	Facility		$407.00	$3,232.79	$5,085.88
Providence Facility/Professional Facility Modifier QK Low / Median / High Price $203.50 / $203.50 / $203.50	Facility	QK	$203.50	$203.50	$203.50
Providence Facility/Professional Facility Modifier QX Low / Median / High Price $203.50 / $203.50 / $203.50	Facility	QX	$203.50	$203.50	$203.50
Providence Facility/Professional Facility Modifier QY Low / Median / High Price $203.50 / $203.50 / $203.50	Facility	QY	$203.50	$203.50	$203.50
Providence Facility/Professional Professional Modifier QK Low / Median / High Price $142.50 / $152.50 / $203.50	Professional	QK	$142.50	$152.50	$203.50
Providence Facility/Professional Professional Modifier QX Low / Median / High Price $142.50 / $152.50 / $203.50	Professional	QX	$142.50	$152.50	$203.50
Providence Facility/Professional Professional Modifier QY Low / Median / High Price $142.50 / $152.50 / $203.50	Professional	QY	$142.50	$152.50	$203.50