Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $1,000.00 / $1,548.82 / $1,548.82	Professional	AA	$1,000.00	$1,548.82	$1,548.82
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $812.83 / $954.99 / $1,148.15	Professional	QZ	$812.83	$954.99	$1,148.15
Moda Health Facility/Professional Professional Modifier AA Low / Median / High Price $1,000.00 / $1,096.48 / $1,548.82	Professional	AA	$1,000.00	$1,096.48	$1,548.82
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