Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier QK Low / Median / High Price $478.63 / $478.63 / $478.63	Facility	QK	$478.63	$478.63	$478.63
Aetna Facility/Professional Facility Modifier QX Low / Median / High Price $588.84 / $912.01 / $1,318.26	Facility	QX	$588.84	$912.01	$1,318.26
Aetna Facility/Professional Facility Modifier QY Low / Median / High Price $323.59 / $323.59 / $407.38	Facility	QY	$323.59	$323.59	$407.38
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $223.87 / $1,348.96 / $2,041.74	Professional	AA	$223.87	$1,348.96	$2,041.74
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $478.63 / $1,445.44 / $1,949.84	Professional	QZ	$478.63	$1,445.44	$1,949.84
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $346.74 / $354.81 / $478.63	Professional	AA	$346.74	$354.81	$478.63
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $199.53 / $199.53 / $199.53	Professional	QZ	$199.53	$199.53	$199.53
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 $141.25 / $316.23 / $467.74	Professional	AA	$141.25	$316.23	$467.74
Geisinger Facility/Professional Professional Modifier QZ Low / Median / High Price $141.25 / $316.23 / $467.74	Professional	QZ	$141.25	$316.23	$467.74
Highmark BCBS Facility/Professional Professional Modifier AA Low / Median / High Price $549.54 / $724.44 / $1,288.25	Professional	AA	$549.54	$724.44	$1,288.25
Highmark BCBS Facility/Professional Professional Modifier QZ Low / Median / High Price $426.58 / $660.69 / $691.83	Professional	QZ	$426.58	$660.69	$691.83
Martin's Point Facility/Professional Facility Modifier QK Low / Median / High Price $478.63 / $478.63 / $478.63	Facility	QK	$478.63	$478.63	$478.63
Martin's Point Facility/Professional Facility Modifier QX Low / Median / High Price $588.84 / $912.01 / $1,318.26	Facility	QX	$588.84	$912.01	$1,318.26
Martin's Point Facility/Professional Facility Modifier QY Low / Median / High Price $323.59 / $323.59 / $407.38	Facility	QY	$323.59	$323.59	$407.38
Martin's Point Facility/Professional Professional Modifier AA Low / Median / High Price $234.42 / $1,348.96 / $1,995.26	Professional	AA	$234.42	$1,348.96	$1,995.26
Martin's Point Facility/Professional Professional Modifier QZ Low / Median / High Price $478.63 / $1,445.44 / $1,949.84	Professional	QZ	$478.63	$1,445.44	$1,949.84