Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $524.81 / $870.96	Facility		$41.69	$524.81	$870.96
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $181.97 / $870.96 / $1,698.24	Professional	AA	$181.97	$870.96	$1,698.24
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $208.93 / $407.38 / $724.44	Professional	QK	$208.93	$407.38	$724.44
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $199.53 / $416.87 / $741.31	Professional	QX	$199.53	$416.87	$741.31
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $269.15 / $398.11 / $691.83	Professional	QY	$269.15	$398.11	$691.83
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $234.42 / $794.33 / $1,621.81	Professional	QZ	$234.42	$794.33	$1,621.81
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $134.90 / $162.18 / $758.58	Professional	AA	$134.90	$162.18	$758.58
Ambetter Facility/Professional Professional Modifier QK Low / Median / High Price $72.44 / $257.04 / $295.12	Professional	QK	$72.44	$257.04	$295.12
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $72.44 / $91.20 / $436.52	Professional	QX	$72.44	$91.20	$436.52
Ambetter Facility/Professional Professional Modifier QY Low / Median / High Price $72.44 / $72.44 / $229.09	Professional	QY	$72.44	$72.44	$229.09
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $117.49 / $208.93 / $977.24	Professional	QZ	$117.49	$208.93	$977.24
Cigna Facility/Professional Facility Modifier Low / Median / High Price $61.66 / $61.66 / $53,703.18	Facility		$61.66	$61.66	$53,703.18
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
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $446.68 / $446.68 / $446.68	Facility		$446.68	$446.68	$446.68
Highmark BCBS Facility/Professional Professional Modifier AA Low / Median / High Price $245.47 / $630.96 / $891.25	Professional	AA	$245.47	$630.96	$891.25
Highmark BCBS Facility/Professional Professional Modifier QK Low / Median / High Price $263.03 / $724.44 / $954.99	Professional	QK	$263.03	$724.44	$954.99
Highmark BCBS Facility/Professional Professional Modifier QX Low / Median / High Price $245.47 / $676.08 / $851.14	Professional	QX	$245.47	$676.08	$851.14
Highmark BCBS Facility/Professional Professional Modifier QY Low / Median / High Price $213.80 / $549.54 / $831.76	Professional	QY	$213.80	$549.54	$831.76
Highmark BCBS Facility/Professional Professional Modifier QZ Low / Median / High Price $245.47 / $512.86 / $630.96	Professional	QZ	$245.47	$512.86	$630.96
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $50,118.72 / $53,703.18 / $75,857.76	Facility		$50,118.72	$53,703.18	$75,857.76
Univera Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $102.33 / $218.78	Facility		$102.33	$102.33	$218.78