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 / $954.99	Facility	QZ	$954.99	$954.99	$954.99
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $371.54 / $602.56 / $977.24	Professional	AA	$371.54	$602.56	$977.24
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $316.23 / $616.60 / $831.76	Professional	QZ	$316.23	$616.60	$831.76
Moda Health Facility/Professional Facility Modifier QZ Low / Median / High Price $954.99 / $954.99 / $954.99	Facility	QZ	$954.99	$954.99	$954.99
Moda Health Facility/Professional Professional Modifier AA Low / Median / High Price $467.74 / $707.95 / $1,148.15	Professional	AA	$467.74	$707.95	$1,148.15
Moda Health Facility/Professional Professional Modifier QZ Low / Median / High Price $478.63 / $630.96 / $1,348.96	Professional	QZ	$478.63	$630.96	$1,348.96
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