Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $2,570.40 / $3,715.35 / $4,570.88	Professional	AA	$2,570.40	$3,715.35	$4,570.88
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $912.01 / $1,548.82 / $3,019.95	Professional	QZ	$912.01	$1,548.82	$3,019.95
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $323.59 / $323.59 / $1,096.48	Professional	AA	$323.59	$323.59	$1,096.48
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $363.08 / $363.08 / $1,174.90	Professional	QZ	$363.08	$363.08	$1,174.90
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 $257.04 / $588.84 / $870.96	Professional	AA	$257.04	$588.84	$870.96
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 AA Low / Median / High Price $891.25 / $1,584.89 / $2,754.23	Professional	AA	$891.25	$1,584.89	$2,754.23
Highmark BCBS Facility/Professional Professional Modifier QZ Low / Median / High Price $851.14 / $1,202.26 / $1,380.38	Professional	QZ	$851.14	$1,202.26	$1,380.38
Martin's Point Facility/Professional Professional Modifier AA Low / Median / High Price $1,148.15 / $3,090.30 / $4,265.80	Professional	AA	$1,148.15	$3,090.30	$4,265.80
Martin's Point Facility/Professional Professional Modifier QZ Low / Median / High Price $912.01 / $1,548.82 / $3,019.95	Professional	QZ	$912.01	$1,548.82	$3,019.95