Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $645.65 / $1,288.25 / $2,041.74	Professional	AA	$645.65	$1,288.25	$2,041.74
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $794.33 / $1,412.54 / $1,995.26	Professional	QZ	$794.33	$1,412.54	$1,995.26
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $851.14 / $851.14 / $851.14	Professional	AA	$851.14	$851.14	$851.14
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $162.18 / $181.97 / $218.78	Professional	QZ	$162.18	$181.97	$218.78
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 $117.49 / $263.03 / $389.05	Professional	AA	$117.49	$263.03	$389.05
Geisinger Facility/Professional Professional Modifier QZ Low / Median / High Price $117.49 / $263.03 / $389.05	Professional	QZ	$117.49	$263.03	$389.05
Highmark BCBS Facility/Professional Professional Modifier AA Low / Median / High Price $562.34 / $933.25 / $2,187.76	Professional	AA	$562.34	$933.25	$2,187.76
Highmark BCBS Facility/Professional Professional Modifier QZ Low / Median / High Price $446.68 / $588.84 / $1,202.26	Professional	QZ	$446.68	$588.84	$1,202.26
Martin's Point Facility/Professional Professional Modifier AA Low / Median / High Price $645.65 / $1,288.25 / $2,041.74	Professional	AA	$645.65	$1,288.25	$2,041.74
Martin's Point Facility/Professional Professional Modifier QZ Low / Median / High Price $794.33 / $1,412.54 / $1,698.24	Professional	QZ	$794.33	$1,412.54	$1,698.24