Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier QX Low / Median / High Price $245.47 / $245.47 / $245.47	Facility	QX	$245.47	$245.47	$245.47
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $154.88 / $851.14 / $1,122.02	Professional	AA	$154.88	$851.14	$1,122.02
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $102.33 / $457.09 / $1,047.13	Professional	QZ	$102.33	$457.09	$1,047.13
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $125.89 / $125.89 / $134.90	Professional	AA	$125.89	$125.89	$134.90
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $144.54 / $144.54 / $162.18	Professional	QZ	$144.54	$144.54	$162.18
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 $117.49 / $263.03 / $389.05	Professional	AA	$117.49	$263.03	$389.05
Geisinger Facility/Professional Professional Modifier QZ Low / Median / High Price $117.49 / $263.03 / $389.05	Professional	QZ	$117.49	$263.03	$389.05
Highmark BCBS Facility/Professional Professional Modifier AA Low / Median / High Price $398.11 / $478.63 / $562.34	Professional	AA	$398.11	$478.63	$562.34
Martin's Point Facility/Professional Facility Modifier QX Low / Median / High Price $245.47 / $245.47 / $245.47	Facility	QX	$245.47	$245.47	$245.47
Martin's Point Facility/Professional Professional Modifier AA Low / Median / High Price $239.88 / $831.76 / $1,122.02	Professional	AA	$239.88	$831.76	$1,122.02
Martin's Point Facility/Professional Professional Modifier QZ Low / Median / High Price $102.33 / $457.09 / $1,122.02	Professional	QZ	$102.33	$457.09	$1,122.02