Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $380.19 / $1,258.93 / $1,258.93	Professional	QZ	$380.19	$1,258.93	$1,258.93
Cigna Facility/Professional Facility Modifier QK Low / Median / High Price $30.90 / $30.90 / $30.90	Facility	QK	$30.90	$30.90	$30.90
Cigna Facility/Professional Facility Modifier QX Low / Median / High Price $30.90 / $30.90 / $30.90	Facility	QX	$30.90	$30.90	$30.90
Cigna Facility/Professional Facility Modifier QY Low / Median / High Price $30.90 / $30.90 / $30.90	Facility	QY	$30.90	$30.90	$30.90
Geisinger Facility/Professional Professional Modifier QZ Low / Median / High Price $257.04 / $588.84 / $870.96	Professional	QZ	$257.04	$588.84	$870.96
Highmark BCBS Facility/Professional Professional Modifier QZ Low / Median / High Price $1,949.84 / $2,089.30 / $2,290.87	Professional	QZ	$1,949.84	$2,089.30	$2,290.87
Martin's Point Facility/Professional Professional Modifier QZ Low / Median / High Price $380.19 / $380.19 / $380.19	Professional	QZ	$380.19	$380.19	$380.19