Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier QZ Low / Median / High Price $950.00 / $950.00 / $1,646.16	Facility	QZ	$950.00	$950.00	$1,646.16
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $172.30 / $786.24 / $1,540.00	Professional	AA	$172.30	$786.24	$1,540.00
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $91.16 / $91.16 / $91.16	Professional	QX	$91.16	$91.16	$91.16
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $649.64 / $649.64 / $649.64	Professional	QY	$649.64	$649.64	$649.64
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $500.96 / $702.00 / $928.29	Professional	QZ	$500.96	$702.00	$928.29
Providence Facility/Professional Facility Modifier QK Low / Median / High Price $244.20 / $244.20 / $244.20	Facility	QK	$244.20	$244.20	$244.20
Providence Facility/Professional Facility Modifier QX Low / Median / High Price $244.20 / $244.20 / $244.20	Facility	QX	$244.20	$244.20	$244.20
Providence Facility/Professional Facility Modifier QY Low / Median / High Price $244.20 / $244.20 / $244.20	Facility	QY	$244.20	$244.20	$244.20
Providence Facility/Professional Professional Modifier QK Low / Median / High Price $171.00 / $183.00 / $244.20	Professional	QK	$171.00	$183.00	$244.20
Providence Facility/Professional Professional Modifier QX Low / Median / High Price $171.00 / $183.00 / $244.20	Professional	QX	$171.00	$183.00	$244.20
Providence Facility/Professional Professional Modifier QY Low / Median / High Price $171.00 / $183.00 / $244.20	Professional	QY	$171.00	$183.00	$244.20