Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier AA Low / Median / High Price $660.69 / $660.69 / $660.69	Facility	AA	$660.69	$660.69	$660.69
Aetna Facility/Professional Facility Modifier QK Low / Median / High Price $208.93 / $251.19 / $489.78	Facility	QK	$208.93	$251.19	$489.78
Aetna Facility/Professional Facility Modifier QX Low / Median / High Price $676.08 / $707.95 / $891.25	Facility	QX	$676.08	$707.95	$891.25
Aetna Facility/Professional Facility Modifier QY Low / Median / High Price $398.11 / $478.63 / $489.78	Facility	QY	$398.11	$478.63	$489.78
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $537.03 / $1,122.02 / $1,819.70	Professional	AA	$537.03	$1,122.02	$1,819.70
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $478.63 / $1,174.90 / $1,778.28	Professional	QZ	$478.63	$1,174.90	$1,778.28
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $181.97 / $389.05 / $645.65	Professional	AA	$181.97	$389.05	$645.65
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $144.54 / $162.18 / $251.19	Professional	QZ	$144.54	$162.18	$251.19
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 $331.13 / $537.03 / $954.99	Professional	AA	$331.13	$537.03	$954.99
Highmark BCBS Facility/Professional Professional Modifier QZ Low / Median / High Price $316.23 / $457.09 / $549.54	Professional	QZ	$316.23	$457.09	$549.54
Martin's Point Facility/Professional Facility Modifier AA Low / Median / High Price $660.69 / $660.69 / $660.69	Facility	AA	$660.69	$660.69	$660.69
Martin's Point Facility/Professional Facility Modifier QK Low / Median / High Price $208.93 / $251.19 / $489.78	Facility	QK	$208.93	$251.19	$489.78
Martin's Point Facility/Professional Facility Modifier QX Low / Median / High Price $676.08 / $707.95 / $891.25	Facility	QX	$676.08	$707.95	$891.25
Martin's Point Facility/Professional Facility Modifier QY Low / Median / High Price $398.11 / $478.63 / $489.78	Facility	QY	$398.11	$478.63	$489.78
Martin's Point Facility/Professional Professional Modifier AA Low / Median / High Price $524.81 / $1,096.48 / $1,819.70	Professional	AA	$524.81	$1,096.48	$1,819.70
Martin's Point Facility/Professional Professional Modifier QZ Low / Median / High Price $489.78 / $1,202.26 / $1,778.28	Professional	QZ	$489.78	$1,202.26	$1,778.28