Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $776.25 / $1,548.82 / $1,949.84	Professional	AA	$776.25	$1,548.82	$1,949.84
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $851.14 / $851.14 / $851.14	Professional	QZ	$851.14	$851.14	$851.14
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
Geisinger Facility/Professional Professional Modifier AA Low / Median / High Price $93.33 / $213.80 / $309.03	Professional	AA	$93.33	$213.80	$309.03
Geisinger Facility/Professional Professional Modifier QZ Low / Median / High Price $93.33 / $213.80 / $309.03	Professional	QZ	$93.33	$213.80	$309.03
Highmark BCBS Facility/Professional Professional Modifier AA Low / Median / High Price $724.44 / $954.99 / $1,202.26	Professional	AA	$724.44	$954.99	$1,202.26
Martin's Point Facility/Professional Professional Modifier AA Low / Median / High Price $407.38 / $1,412.54 / $1,949.84	Professional	AA	$407.38	$1,412.54	$1,949.84
Martin's Point Facility/Professional Professional Modifier QZ Low / Median / High Price $851.14 / $851.14 / $851.14	Professional	QZ	$851.14	$851.14	$851.14