Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $78.51 / $78.51 / $78.51	Professional	AA	$78.51	$78.51	$78.51
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $65.02 / $65.02 / $65.02	Professional	QX	$65.02	$65.02	$65.02
Providence Facility/Professional Facility Modifier QK Low / Median / High Price $162.80 / $162.80 / $162.80	Facility	QK	$162.80	$162.80	$162.80
Providence Facility/Professional Facility Modifier QX Low / Median / High Price $162.80 / $162.80 / $162.80	Facility	QX	$162.80	$162.80	$162.80
Providence Facility/Professional Facility Modifier QY Low / Median / High Price $162.80 / $162.80 / $162.80	Facility	QY	$162.80	$162.80	$162.80
Providence Facility/Professional Professional Modifier QX Low / Median / High Price $114.00 / $122.00 / $162.80	Professional	QX	$114.00	$122.00	$162.80
Providence Facility/Professional Professional Modifier QY Low / Median / High Price $114.00 / $122.00 / $162.80	Professional	QY	$114.00	$122.00	$162.80
Regence BlueShield Facility/Professional Professional Modifier QX Low / Median / High Price $115.50 / $138.00 / $166.84	Professional	QX	$115.50	$138.00	$166.84
Regence BlueShield Facility/Professional Professional Modifier QY Low / Median / High Price $115.50 / $138.00 / $166.84	Professional	QY	$115.50	$138.00	$166.84