Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $912.01 / $1,148.15 / $2,398.83	Professional	AA	$912.01	$1,148.15	$2,398.83
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $676.08 / $954.99 / $1,621.81	Professional	QZ	$676.08	$954.99	$1,621.81
Moda Health Facility/Professional Professional Modifier AA Low / Median / High Price $891.25 / $1,258.93 / $2,398.83	Professional	AA	$891.25	$1,258.93	$2,398.83
Moda Health Facility/Professional Professional Modifier QZ Low / Median / High Price $676.08 / $676.08 / $1,148.15	Professional	QZ	$676.08	$676.08	$1,148.15
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