Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier QZ Low / Median / High Price $954.99 / $954.99 / $1,659.59	Facility	QZ	$954.99	$954.99	$1,659.59
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $457.09 / $645.65 / $977.24	Professional	AA	$457.09	$645.65	$977.24
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $309.03 / $398.11 / $537.03	Professional	QK	$309.03	$398.11	$537.03
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $288.40 / $389.05 / $512.86	Professional	QX	$288.40	$389.05	$512.86
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $323.59 / $398.11 / $467.74	Professional	QY	$323.59	$398.11	$467.74
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $512.86 / $645.65 / $831.76	Professional	QZ	$512.86	$645.65	$831.76
Moda Health Facility/Professional Facility Modifier QZ Low / Median / High Price $954.99 / $954.99 / $1,659.59	Facility	QZ	$954.99	$954.99	$1,659.59
Moda Health Facility/Professional Professional Modifier AA Low / Median / High Price $489.78 / $831.76 / $1,258.93	Professional	AA	$489.78	$831.76	$1,258.93
Moda Health Facility/Professional Professional Modifier QK Low / Median / High Price $295.12 / $398.11 / $588.84	Professional	QK	$295.12	$398.11	$588.84
Moda Health Facility/Professional Professional Modifier QX Low / Median / High Price $275.42 / $380.19 / $575.44	Professional	QX	$275.42	$380.19	$575.44
Moda Health Facility/Professional Professional Modifier QY Low / Median / High Price $302.00 / $407.38 / $645.65	Professional	QY	$302.00	$407.38	$645.65
Moda Health Facility/Professional Professional Modifier QZ Low / Median / High Price $457.09 / $616.60 / $933.25	Professional	QZ	$457.09	$616.60	$933.25
Providence Facility/Professional Facility Modifier QK Low / Median / High Price $30.90 / $30.90 / $30.90	Facility	QK	$30.90	$30.90	$30.90
Providence Facility/Professional Facility Modifier QX Low / Median / High Price $30.90 / $30.90 / $30.90	Facility	QX	$30.90	$30.90	$30.90
Providence Facility/Professional Facility Modifier QY Low / Median / High Price $30.90 / $30.90 / $30.90	Facility	QY	$30.90	$30.90	$30.90
Providence Facility/Professional Professional Modifier QK Low / Median / High Price $181.97 / $181.97 / $181.97	Professional	QK	$181.97	$181.97	$181.97
Providence Facility/Professional Professional Modifier QX Low / Median / High Price $181.97 / $181.97 / $181.97	Professional	QX	$181.97	$181.97	$181.97
Providence Facility/Professional Professional Modifier QY Low / Median / High Price $181.97 / $181.97 / $181.97	Professional	QY	$181.97	$181.97	$181.97