Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $8,511.38 / $8,511.38 / $8,511.38	Professional	QZ	$8,511.38	$8,511.38	$8,511.38
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 QZ Low / Median / High Price $208.93 / $478.63 / $707.95	Professional	QZ	$208.93	$478.63	$707.95
Martin's Point Facility/Professional Professional Modifier QZ Low / Median / High Price $8,511.38 / $8,511.38 / $8,511.38	Professional	QZ	$8,511.38	$8,511.38	$8,511.38