Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $870.96 / $1,698.24 / $2,570.40	Professional	AA	$870.96	$1,698.24	$2,570.40
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $186.21 / $1,698.24 / $2,187.76	Professional	QZ	$186.21	$1,698.24	$2,187.76
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $537.03 / $537.03 / $645.65	Professional	AA	$537.03	$537.03	$645.65
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $199.53 / $199.53 / $263.03	Professional	QZ	$199.53	$199.53	$263.03
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 $407.38 / $812.83 / $1,548.82	Professional	AA	$407.38	$812.83	$1,548.82
Highmark BCBS Facility/Professional Professional Modifier QZ Low / Median / High Price $467.74 / $812.83 / $933.25	Professional	QZ	$467.74	$812.83	$933.25
Martin's Point Facility/Professional Professional Modifier AA Low / Median / High Price $660.69 / $1,659.59 / $2,570.40	Professional	AA	$660.69	$1,659.59	$2,570.40
Martin's Point Facility/Professional Professional Modifier QZ Low / Median / High Price $186.21 / $954.99 / $2,187.76	Professional	QZ	$186.21	$954.99	$2,187.76