Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier AA Low / Median / High Price $389.05 / $389.05 / $389.05	Facility	AA	$389.05	$389.05	$389.05
Aetna Facility/Professional Facility Modifier QK Low / Median / High Price $181.97 / $181.97 / $676.08	Facility	QK	$181.97	$181.97	$676.08
Aetna Facility/Professional Facility Modifier QX Low / Median / High Price $630.96 / $691.83 / $870.96	Facility	QX	$630.96	$691.83	$870.96
Aetna Facility/Professional Facility Modifier QY Low / Median / High Price $251.19 / $316.23 / $575.44	Facility	QY	$251.19	$316.23	$575.44
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $478.63 / $1,023.29 / $2,041.74	Professional	AA	$478.63	$1,023.29	$2,041.74
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $181.97 / $257.04 / $588.84	Professional	AA	$181.97	$257.04	$588.84
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 $281.84 / $512.86 / $1,148.15	Professional	AA	$281.84	$512.86	$1,148.15
Martin's Point Facility/Professional Facility Modifier AA Low / Median / High Price $389.05 / $389.05 / $389.05	Facility	AA	$389.05	$389.05	$389.05
Martin's Point Facility/Professional Facility Modifier QK Low / Median / High Price $181.97 / $181.97 / $676.08	Facility	QK	$181.97	$181.97	$676.08
Martin's Point Facility/Professional Facility Modifier QX Low / Median / High Price $630.96 / $691.83 / $870.96	Facility	QX	$630.96	$691.83	$870.96
Martin's Point Facility/Professional Facility Modifier QY Low / Median / High Price $251.19 / $316.23 / $575.44	Facility	QY	$251.19	$316.23	$575.44
Martin's Point Facility/Professional Professional Modifier AA Low / Median / High Price $436.52 / $933.25 / $1,737.80	Professional	AA	$436.52	$933.25	$1,737.80