Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $33.81 / $390.00 / $730.00	Facility		$33.81	$390.00	$730.00
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $141.58 / $610.00 / $1,393.20	Professional	AA	$141.58	$610.00	$1,393.20
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $227.15 / $492.65 / $645.00	Professional	QX	$227.15	$492.65	$645.00
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $315.00 / $531.00 / $607.50	Professional	QY	$315.00	$531.00	$607.50
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $151.68 / $980.40 / $1,252.50	Professional	QZ	$151.68	$980.40	$1,252.50
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $120.54 / $158.34 / $772.31	Professional	AA	$120.54	$158.34	$772.31
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $86.02 / $86.02 / $86.02	Professional	QX	$86.02	$86.02	$86.02
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $102.46 / $102.46 / $160.72	Professional	QZ	$102.46	$102.46	$160.72
Cigna Facility/Professional Professional Modifier QX Low / Median / High Price $150.00 / $150.00 / $150.00	Professional	QX	$150.00	$150.00	$150.00
Cigna Facility/Professional Professional Modifier QY Low / Median / High Price $150.00 / $150.00 / $150.00	Professional	QY	$150.00	$150.00	$150.00
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $375.00 / $375.00 / $375.00	Facility		$375.00	$375.00	$375.00
Highmark BCBS Facility/Professional Professional Modifier AA Low / Median / High Price $178.50 / $465.30 / $619.47	Professional	AA	$178.50	$465.30	$619.47
Highmark BCBS Facility/Professional Professional Modifier QX Low / Median / High Price $150.80 / $531.51 / $610.48	Professional	QX	$150.80	$531.51	$610.48
Highmark BCBS Facility/Professional Professional Modifier QY Low / Median / High Price $168.20 / $497.13 / $570.40	Professional	QY	$168.20	$497.13	$570.40
Highmark BCBS Facility/Professional Professional Modifier QZ Low / Median / High Price $162.08 / $214.00 / $491.40	Professional	QZ	$162.08	$214.00	$491.40
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $555.00 / $597.00 / $74,999.25	Facility		$555.00	$597.00	$74,999.25
MVP Health Care Facility/Professional Professional Modifier QX Low / Median / High Price $150.00 / $150.00 / $150.00	Professional	QX	$150.00	$150.00	$150.00
MVP Health Care Facility/Professional Professional Modifier QY Low / Median / High Price $150.00 / $150.00 / $150.00	Professional	QY	$150.00	$150.00	$150.00
Univera Facility/Professional Facility Modifier Low / Median / High Price $176.00 / $176.00 / $176.00	Facility		$176.00	$176.00	$176.00