Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $199.53 / $199.53 / $977.24	Professional	AA	$199.53	$199.53	$977.24
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $398.11 / $436.52 / $549.54	Professional	QZ	$398.11	$436.52	$549.54
Moda Health Facility/Professional Professional Modifier AA Low / Median / High Price $199.53 / $199.53 / $977.24	Professional	AA	$199.53	$199.53	$977.24
Moda Health Facility/Professional Professional Modifier QZ Low / Median / High Price $436.52 / $436.52 / $478.63	Professional	QZ	$436.52	$436.52	$478.63
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