Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier QK Low / Median / High Price $250.07 / $345.33 / $392.96	Facility	QK	$250.07	$345.33	$392.96
Aetna Facility/Professional Facility Modifier QX Low / Median / High Price $692.50 / $860.51 / $1,235.30	Facility	QX	$692.50	$860.51	$1,235.30
Aetna Facility/Professional Facility Modifier QY Low / Median / High Price $176.09 / $176.09 / $176.09	Facility	QY	$176.09	$176.09	$176.09
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $169.99 / $1,120.00 / $1,820.00	Professional	AA	$169.99	$1,120.00	$1,820.00
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $216.10 / $216.10 / $216.10	Professional	AA	$216.10	$216.10	$216.10
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $180.45 / $180.45 / $180.45	Professional	QZ	$180.45	$180.45	$180.45
Highmark BCBS Facility/Professional Professional Modifier AA Low / Median / High Price $469.76 / $795.96 / $1,596.78	Professional	AA	$469.76	$795.96	$1,596.78
Highmark BCBS Facility/Professional Professional Modifier QZ Low / Median / High Price $480.60 / $550.11 / $649.01	Professional	QZ	$480.60	$550.11	$649.01
Martin's Point Facility/Professional Facility Modifier QK Low / Median / High Price $250.07 / $345.33 / $392.96	Facility	QK	$250.07	$345.33	$392.96
Martin's Point Facility/Professional Facility Modifier QX Low / Median / High Price $692.50 / $860.51 / $1,235.30	Facility	QX	$692.50	$860.51	$1,235.30
Martin's Point Facility/Professional Facility Modifier QY Low / Median / High Price $176.09 / $176.09 / $176.09	Facility	QY	$176.09	$176.09	$176.09
Martin's Point Facility/Professional Professional Modifier AA Low / Median / High Price $514.91 / $1,038.45 / $1,540.00	Professional	AA	$514.91	$1,038.45	$1,540.00
United Facility/Professional Professional Modifier AA Low / Median / High Price $88.00 / $88.00 / $88.00	Professional	AA	$88.00	$88.00	$88.00