Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $426.58 / $724.44	Facility		$173.78	$426.58	$724.44
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $213.80 / $851.14 / $1,513.56	Professional	AA	$213.80	$851.14	$1,513.56
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $223.87 / $371.54 / $676.08	Professional	QK	$223.87	$371.54	$676.08
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $223.87 / $371.54 / $660.69	Professional	QX	$223.87	$371.54	$660.69
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $239.88 / $346.74 / $660.69	Professional	QY	$239.88	$346.74	$660.69
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $239.88 / $602.56 / $1,348.96	Professional	QZ	$239.88	$602.56	$1,348.96
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $117.49 / $117.49 / $117.49	Professional	AA	$117.49	$117.49	$117.49
Ambetter Facility/Professional Professional Modifier QK Low / Median / High Price $72.44 / $194.98 / $295.12	Professional	QK	$72.44	$194.98	$295.12
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $63.10 / $81.28 / $257.04	Professional	QX	$63.10	$81.28	$257.04
Ambetter Facility/Professional Professional Modifier QY Low / Median / High Price $63.10 / $63.10 / $229.09	Professional	QY	$63.10	$63.10	$229.09
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $100.00 / $144.54 / $977.24	Professional	QZ	$100.00	$144.54	$977.24
Cigna Facility/Professional Facility Modifier Low / Median / High Price $61.66 / $61.66 / $53,703.18	Facility		$61.66	$61.66	$53,703.18
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
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $371.54 / $371.54 / $371.54	Facility		$371.54	$371.54	$371.54
Highmark BCBS Facility/Professional Professional Modifier AA Low / Median / High Price $251.19 / $562.34 / $707.95	Professional	AA	$251.19	$562.34	$707.95
Highmark BCBS Facility/Professional Professional Modifier QK Low / Median / High Price $245.47 / $630.96 / $776.25	Professional	QK	$245.47	$630.96	$776.25
Highmark BCBS Facility/Professional Professional Modifier QX Low / Median / High Price $269.15 / $616.60 / $776.25	Professional	QX	$269.15	$616.60	$776.25
Highmark BCBS Facility/Professional Professional Modifier QY Low / Median / High Price $257.04 / $549.54 / $741.31	Professional	QY	$257.04	$549.54	$741.31
Highmark BCBS Facility/Professional Professional Modifier QZ Low / Median / High Price $186.21 / $467.74 / $602.56	Professional	QZ	$186.21	$467.74	$602.56
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $50,118.72 / $53,703.18 / $75,857.76	Facility		$50,118.72	$53,703.18	$75,857.76
Univera Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $81.28 / $177.83	Facility		$81.28	$81.28	$177.83