Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $512.86 / $794.33 / $1,288.25	Professional	AA	$512.86	$794.33	$1,288.25
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $354.81 / $691.83 / $912.01	Professional	QZ	$354.81	$691.83	$912.01
Moda Health Facility/Professional Professional Modifier AA Low / Median / High Price $588.84 / $891.25 / $1,318.26	Professional	AA	$588.84	$891.25	$1,318.26
Moda Health Facility/Professional Professional Modifier QZ Low / Median / High Price $173.78 / $660.69 / $851.14	Professional	QZ	$173.78	$660.69	$851.14
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