Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $294.00 / $460.46 / $518.40	Facility		$294.00	$460.46	$518.40
Aetna Facility/Professional Facility Modifier AA Low / Median / High Price $429.00 / $429.00 / $429.00	Facility	AA	$429.00	$429.00	$429.00
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $498.30 / $516.73 / $584.50	Professional	AA	$498.30	$516.73	$584.50
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $264.62 / $317.54 / $436.01	Professional	QK	$264.62	$317.54	$436.01
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $210.00 / $290.68 / $427.46	Professional	QX	$210.00	$290.68	$427.46
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $262.60 / $292.25 / $556.44	Professional	QY	$262.60	$292.25	$556.44
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $480.38 / $556.44 / $669.21	Professional	QZ	$480.38	$556.44	$669.21
CareSource Facility/Professional Facility Modifier Low / Median / High Price $27.39 / $109.57 / $255.66	Facility		$27.39	$109.57	$255.66
Highmark BCBS Facility/Professional Professional Modifier AA Low / Median / High Price $582.28 / $582.28 / $583.41	Professional	AA	$582.28	$582.28	$583.41
Highmark BCBS Facility/Professional Professional Modifier QK Low / Median / High Price $440.94 / $577.01 / $734.56	Professional	QK	$440.94	$577.01	$734.56
Highmark BCBS Facility/Professional Professional Modifier QX Low / Median / High Price $375.35 / $583.23 / $765.75	Professional	QX	$375.35	$583.23	$765.75
Highmark BCBS Facility/Professional Professional Modifier QY Low / Median / High Price $385.98 / $446.65 / $777.20	Professional	QY	$385.98	$446.65	$777.20
Highmark BCBS Facility/Professional Professional Modifier QZ Low / Median / High Price $380.13 / $489.80 / $660.44	Professional	QZ	$380.13	$489.80	$660.44
United Facility/Professional Professional Modifier AA Low / Median / High Price $75.00 / $75.00 / $75.00	Professional	AA	$75.00	$75.00	$75.00
United Facility/Professional Professional Modifier QX Low / Median / High Price $211.50 / $211.50 / $211.50	Professional	QX	$211.50	$211.50	$211.50