Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier QK Low / Median / High Price $208.93 / $208.93 / $208.93	Facility	QK	$208.93	$208.93	$208.93
Aetna Facility/Professional Facility Modifier QX Low / Median / High Price $891.25 / $891.25 / $891.25	Facility	QX	$891.25	$891.25	$891.25
Aetna Facility/Professional Facility Modifier QY Low / Median / High Price $316.23 / $316.23 / $316.23	Facility	QY	$316.23	$316.23	$316.23
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $436.52 / $954.99 / $1,548.82	Professional	AA	$436.52	$954.99	$1,548.82
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $125.89 / $245.47 / $457.09	Professional	AA	$125.89	$245.47	$457.09
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 $93.33 / $213.80 / $309.03	Professional	AA	$93.33	$213.80	$309.03
Highmark BCBS Facility/Professional Professional Modifier AA Low / Median / High Price $354.81 / $562.34 / $870.96	Professional	AA	$354.81	$562.34	$870.96
Martin's Point Facility/Professional Facility Modifier QK Low / Median / High Price $208.93 / $208.93 / $208.93	Facility	QK	$208.93	$208.93	$208.93
Martin's Point Facility/Professional Facility Modifier QX Low / Median / High Price $891.25 / $891.25 / $891.25	Facility	QX	$891.25	$891.25	$891.25
Martin's Point Facility/Professional Facility Modifier QY Low / Median / High Price $316.23 / $316.23 / $316.23	Facility	QY	$316.23	$316.23	$316.23
Martin's Point Facility/Professional Professional Modifier AA Low / Median / High Price $416.87 / $933.25 / $1,513.56	Professional	AA	$416.87	$933.25	$1,513.56