Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $870.96 / $1,071.52 / $1,819.70	Professional	AA	$870.96	$1,071.52	$1,819.70
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $794.33 / $831.76 / $851.14	Professional	QZ	$794.33	$831.76	$851.14
Moda Health Facility/Professional Professional Modifier AA Low / Median / High Price $199.53 / $1,071.52 / $1,698.24	Professional	AA	$199.53	$1,071.52	$1,698.24
Moda Health Facility/Professional Professional Modifier QZ Low / Median / High Price $954.99 / $954.99 / $954.99	Professional	QZ	$954.99	$954.99	$954.99
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