Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $805.10 / $806.60 / $1,707.72	Professional	AA	$805.10	$806.60	$1,707.72
Providence Facility/Professional Facility Modifier QK Low / Median / High Price $244.20 / $244.20 / $244.20	Facility	QK	$244.20	$244.20	$244.20
Providence Facility/Professional Facility Modifier QX Low / Median / High Price $244.20 / $244.20 / $244.20	Facility	QX	$244.20	$244.20	$244.20
Providence Facility/Professional Facility Modifier QY Low / Median / High Price $244.20 / $244.20 / $244.20	Facility	QY	$244.20	$244.20	$244.20
Providence Facility/Professional Professional Modifier QX Low / Median / High Price $174.00 / $187.50 / $244.20	Professional	QX	$174.00	$187.50	$244.20
Providence Facility/Professional Professional Modifier QY Low / Median / High Price $174.00 / $187.50 / $244.20	Professional	QY	$174.00	$187.50	$244.20
Regence BlueShield Facility/Professional Professional Modifier QX Low / Median / High Price $173.25 / $207.00 / $250.26	Professional	QX	$173.25	$207.00	$250.26
Regence BlueShield Facility/Professional Professional Modifier QY Low / Median / High Price $173.25 / $207.00 / $250.26	Professional	QY	$173.25	$207.00	$250.26