Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier QK Low / Median / High Price $549.54 / $549.54 / $549.54	Facility	QK	$549.54	$549.54	$549.54
Aetna Facility/Professional Facility Modifier QX Low / Median / High Price $912.01 / $1,819.70 / $1,819.70	Facility	QX	$912.01	$1,819.70	$1,819.70
Aetna Facility/Professional Facility Modifier QY Low / Median / High Price $660.69 / $660.69 / $660.69	Facility	QY	$660.69	$660.69	$660.69
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $707.95 / $1,548.82 / $2,884.03	Professional	AA	$707.95	$1,548.82	$2,884.03
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $562.34 / $1,148.15 / $2,089.30	Professional	QZ	$562.34	$1,148.15	$2,089.30
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $181.97 / $398.11 / $645.65	Professional	AA	$181.97	$398.11	$645.65
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $100.00 / $239.88 / $331.13	Professional	QZ	$100.00	$239.88	$331.13
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
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 $436.52 / $776.25 / $1,348.96	Professional	AA	$436.52	$776.25	$1,348.96
Highmark BCBS Facility/Professional Professional Modifier QZ Low / Median / High Price $371.54 / $549.54 / $1,023.29	Professional	QZ	$371.54	$549.54	$1,023.29
Martin's Point Facility/Professional Facility Modifier QK Low / Median / High Price $549.54 / $549.54 / $549.54	Facility	QK	$549.54	$549.54	$549.54
Martin's Point Facility/Professional Facility Modifier QX Low / Median / High Price $912.01 / $1,819.70 / $1,819.70	Facility	QX	$912.01	$1,819.70	$1,819.70
Martin's Point Facility/Professional Facility Modifier QY Low / Median / High Price $660.69 / $660.69 / $660.69	Facility	QY	$660.69	$660.69	$660.69
Martin's Point Facility/Professional Professional Modifier AA Low / Median / High Price $616.60 / $1,412.54 / $2,511.89	Professional	AA	$616.60	$1,412.54	$2,511.89
Martin's Point Facility/Professional Professional Modifier QZ Low / Median / High Price $562.34 / $1,122.02 / $2,089.30	Professional	QZ	$562.34	$1,122.02	$2,089.30