Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier QZ Low / Median / High Price $722.00 / $722.00 / $722.00	Facility	QZ	$722.00	$722.00	$722.00
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $549.40 / $980.00 / $1,400.00	Professional	AA	$549.40	$980.00	$1,400.00
Providence Facility/Professional Facility Modifier QK Low / Median / High Price $162.80 / $162.80 / $162.80	Facility	QK	$162.80	$162.80	$162.80
Providence Facility/Professional Facility Modifier QX Low / Median / High Price $162.80 / $162.80 / $162.80	Facility	QX	$162.80	$162.80	$162.80
Providence Facility/Professional Facility Modifier QY Low / Median / High Price $162.80 / $162.80 / $162.80	Facility	QY	$162.80	$162.80	$162.80