Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $731.50 / $2,000.10 / $3,422.80	Professional	AA	$731.50	$2,000.10	$3,422.80
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $419.65 / $918.50 / $1,487.80	Professional	QX	$419.65	$918.50	$1,487.80
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $319.55 / $989.00 / $1,424.85	Professional	QY	$319.55	$989.00	$1,424.85
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $576.00 / $2,154.30 / $3,663.60	Professional	QZ	$576.00	$2,154.30	$3,663.60
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $455.00 / $1,213.63 / $1,323.96	Professional	AA	$455.00	$1,213.63	$1,323.96
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $139.78 / $1,654.95 / $1,654.95	Professional	QX	$139.78	$1,654.95	$1,654.95
Ambetter Facility/Professional Professional Modifier QY Low / Median / High Price $551.65 / $551.65 / $551.65	Professional	QY	$551.65	$551.65	$551.65
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $186.37 / $510.00 / $510.00	Professional	QZ	$186.37	$510.00	$510.00
Cigna Facility/Professional Professional Modifier QX Low / Median / High Price $180.00 / $180.00 / $180.00	Professional	QX	$180.00	$180.00	$180.00
Cigna Facility/Professional Professional Modifier QY Low / Median / High Price $180.00 / $180.00 / $180.00	Professional	QY	$180.00	$180.00	$180.00
Highmark BCBS Facility/Professional Professional Modifier AA Low / Median / High Price $430.63 / $988.80 / $1,677.96	Professional	AA	$430.63	$988.80	$1,677.96
Highmark BCBS Facility/Professional Professional Modifier QX Low / Median / High Price $340.05 / $1,012.00 / $1,737.60	Professional	QX	$340.05	$1,012.00	$1,737.60
Highmark BCBS Facility/Professional Professional Modifier QY Low / Median / High Price $279.54 / $707.25 / $1,117.25	Professional	QY	$279.54	$707.25	$1,117.25
Highmark BCBS Facility/Professional Professional Modifier QZ Low / Median / High Price $287.13 / $855.45 / $1,334.30	Professional	QZ	$287.13	$855.45	$1,334.30
MVP Health Care Facility/Professional Professional Modifier QX Low / Median / High Price $180.00 / $180.00 / $180.00	Professional	QX	$180.00	$180.00	$180.00
MVP Health Care Facility/Professional Professional Modifier QY Low / Median / High Price $180.00 / $180.00 / $180.00	Professional	QY	$180.00	$180.00	$180.00
United Facility/Professional Professional Modifier QY Low / Median / High Price $80.00 / $80.00 / $90.00	Professional	QY	$80.00	$80.00	$90.00