Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $602.56 / $1,230.27 / $1,584.89	Professional	AA	$602.56	$1,230.27	$1,584.89
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $1,230.27 / $1,412.54 / $1,584.89	Professional	QZ	$1,230.27	$1,412.54	$1,584.89
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $645.65 / $645.65 / $645.65	Professional	AA	$645.65	$645.65	$645.65
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 $537.03 / $537.03 / $616.60	Professional	AA	$537.03	$537.03	$616.60
Martin's Point Facility/Professional Professional Modifier AA Low / Median / High Price $602.56 / $1,202.26 / $2,398.83	Professional	AA	$602.56	$1,202.26	$2,398.83
Martin's Point Facility/Professional Professional Modifier QZ Low / Median / High Price $1,230.27 / $1,412.54 / $1,584.89	Professional	QZ	$1,230.27	$1,412.54	$1,584.89