Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier AA Low / Median / High Price $562.34 / $562.34 / $562.34	Facility	AA	$562.34	$562.34	$562.34
Aetna Facility/Professional Facility Modifier QK Low / Median / High Price $269.15 / $371.54 / $389.05	Facility	QK	$269.15	$371.54	$389.05
Aetna Facility/Professional Facility Modifier QY Low / Median / High Price $416.87 / $416.87 / $524.81	Facility	QY	$416.87	$416.87	$524.81
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $630.96 / $1,288.25 / $2,290.87	Professional	AA	$630.96	$1,288.25	$2,290.87
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $457.09 / $812.83 / $1,905.46	Professional	QZ	$457.09	$812.83	$1,905.46
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $181.97 / $457.09 / $912.01	Professional	AA	$181.97	$457.09	$912.01
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $181.97 / $181.97 / $457.09	Professional	QZ	$181.97	$181.97	$457.09
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 $141.25 / $316.23 / $467.74	Professional	AA	$141.25	$316.23	$467.74
Geisinger Facility/Professional Professional Modifier QZ Low / Median / High Price $141.25 / $316.23 / $467.74	Professional	QZ	$141.25	$316.23	$467.74
Highmark BCBS Facility/Professional Professional Modifier AA Low / Median / High Price $467.74 / $676.08 / $1,380.38	Professional	AA	$467.74	$676.08	$1,380.38
Highmark BCBS Facility/Professional Professional Modifier QZ Low / Median / High Price $436.52 / $616.60 / $812.83	Professional	QZ	$436.52	$616.60	$812.83
Martin's Point Facility/Professional Facility Modifier AA Low / Median / High Price $562.34 / $562.34 / $562.34	Facility	AA	$562.34	$562.34	$562.34
Martin's Point Facility/Professional Facility Modifier QK Low / Median / High Price $269.15 / $371.54 / $389.05	Facility	QK	$269.15	$371.54	$389.05
Martin's Point Facility/Professional Facility Modifier QY Low / Median / High Price $416.87 / $416.87 / $524.81	Facility	QY	$416.87	$416.87	$524.81
Martin's Point Facility/Professional Professional Modifier AA Low / Median / High Price $616.60 / $1,288.25 / $2,398.83	Professional	AA	$616.60	$1,288.25	$2,398.83
Martin's Point Facility/Professional Professional Modifier QZ Low / Median / High Price $446.68 / $812.83 / $1,905.46	Professional	QZ	$446.68	$812.83	$1,905.46