Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier QK Low / Median / High Price $416.87 / $416.87 / $416.87	Facility	QK	$416.87	$416.87	$416.87
Aetna Facility/Professional Facility Modifier QX Low / Median / High Price $812.83 / $812.83 / $812.83	Facility	QX	$812.83	$812.83	$812.83
Aetna Facility/Professional Facility Modifier QY Low / Median / High Price $251.19 / $251.19 / $251.19	Facility	QY	$251.19	$251.19	$251.19
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $467.74 / $1,096.48 / $2,089.30	Professional	AA	$467.74	$1,096.48	$2,089.30
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $354.81 / $891.25 / $1,862.09	Professional	QZ	$354.81	$891.25	$1,862.09
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $141.25 / $181.97 / $524.81	Professional	AA	$141.25	$181.97	$524.81
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $138.04 / $162.18 / $194.98	Professional	QZ	$138.04	$162.18	$194.98
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 AA Low / Median / High Price $93.33 / $213.80 / $309.03	Professional	AA	$93.33	$213.80	$309.03
Geisinger Facility/Professional Professional Modifier QZ Low / Median / High Price $93.33 / $213.80 / $309.03	Professional	QZ	$93.33	$213.80	$309.03
Highmark BCBS Facility/Professional Professional Modifier AA Low / Median / High Price $398.11 / $724.44 / $1,318.26	Professional	AA	$398.11	$724.44	$1,318.26
Highmark BCBS Facility/Professional Professional Modifier QZ Low / Median / High Price $239.88 / $371.54 / $741.31	Professional	QZ	$239.88	$371.54	$741.31
Martin's Point Facility/Professional Facility Modifier QK Low / Median / High Price $416.87 / $416.87 / $416.87	Facility	QK	$416.87	$416.87	$416.87
Martin's Point Facility/Professional Facility Modifier QX Low / Median / High Price $812.83 / $812.83 / $812.83	Facility	QX	$812.83	$812.83	$812.83
Martin's Point Facility/Professional Facility Modifier QY Low / Median / High Price $251.19 / $251.19 / $251.19	Facility	QY	$251.19	$251.19	$251.19
Martin's Point Facility/Professional Professional Modifier AA Low / Median / High Price $457.09 / $1,071.52 / $2,089.30	Professional	AA	$457.09	$1,071.52	$2,089.30
Martin's Point Facility/Professional Professional Modifier QZ Low / Median / High Price $363.08 / $954.99 / $1,862.09	Professional	QZ	$363.08	$954.99	$1,862.09