Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $77.62 / $436.52 / $436.52	Professional	AA	$77.62	$436.52	$436.52
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $64.57 / $363.08 / $537.03	Professional	QX	$64.57	$363.08	$537.03
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $269.15 / $269.15 / $389.05	Professional	QY	$269.15	$269.15	$389.05
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $549.54 / $549.54 / $602.56	Professional	QZ	$549.54	$549.54	$602.56
Moda Health Facility/Professional Professional Modifier AA Low / Median / High Price $77.62 / $436.52 / $602.56	Professional	AA	$77.62	$436.52	$602.56
Moda Health Facility/Professional Professional Modifier QX Low / Median / High Price $64.57 / $64.57 / $398.11	Professional	QX	$64.57	$64.57	$398.11
Moda Health Facility/Professional Professional Modifier QY Low / Median / High Price $281.84 / $281.84 / $398.11	Professional	QY	$281.84	$281.84	$398.11
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
Providence Facility/Professional Professional Modifier QX Low / Median / High Price $120.23 / $120.23 / $120.23	Professional	QX	$120.23	$120.23	$120.23
Providence Facility/Professional Professional Modifier QY Low / Median / High Price $120.23 / $120.23 / $120.23	Professional	QY	$120.23	$120.23	$120.23
Regence BlueShield Facility/Professional Professional Modifier QX Low / Median / High Price $114.82 / $128.82 / $165.96	Professional	QX	$114.82	$128.82	$165.96
Regence BlueShield Facility/Professional Professional Modifier QY Low / Median / High Price $114.82 / $128.82 / $165.96	Professional	QY	$114.82	$128.82	$165.96