Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $33.81 / $400.00 / $730.00	Facility		$33.81	$400.00	$730.00
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $181.15 / $744.60 / $1,565.20	Professional	AA	$181.15	$744.60	$1,565.20
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $233.60 / $484.30 / $713.80	Professional	QK	$233.60	$484.30	$713.80
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $254.10 / $517.70 / $761.10	Professional	QX	$254.10	$517.70	$761.10
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $381.15 / $517.70 / $713.80	Professional	QY	$381.15	$517.70	$713.80
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $181.63 / $980.40 / $1,462.00	Professional	QZ	$181.63	$980.40	$1,462.00
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $158.34 / $182.70 / $882.64	Professional	AA	$158.34	$182.70	$882.64
Ambetter Facility/Professional Professional Modifier QK Low / Median / High Price $60.27 / $162.50 / $386.16	Professional	QK	$60.27	$162.50	$386.16
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $60.18 / $560.00 / $1,103.30	Professional	QX	$60.18	$560.00	$1,103.30
Ambetter Facility/Professional Professional Modifier QY Low / Median / High Price $106.01 / $330.99 / $551.65	Professional	QY	$106.01	$330.99	$551.65
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $120.54 / $160.08 / $408.00	Professional	QZ	$120.54	$160.08	$408.00
Cigna Facility/Professional Professional Modifier QK Low / Median / High Price $150.00 / $150.00 / $150.00	Professional	QK	$150.00	$150.00	$150.00
Cigna Facility/Professional Professional Modifier QX Low / Median / High Price $150.00 / $150.00 / $150.00	Professional	QX	$150.00	$150.00	$150.00
Cigna Facility/Professional Professional Modifier QY Low / Median / High Price $150.00 / $150.00 / $150.00	Professional	QY	$150.00	$150.00	$150.00
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $375.00 / $375.00 / $375.00	Facility		$375.00	$375.00	$375.00
Highmark BCBS Facility/Professional Professional Modifier AA Low / Median / High Price $257.04 / $575.25 / $743.65	Professional	AA	$257.04	$575.25	$743.65
Highmark BCBS Facility/Professional Professional Modifier QK Low / Median / High Price $222.00 / $635.92 / $799.20	Professional	QK	$222.00	$635.92	$799.20
Highmark BCBS Facility/Professional Professional Modifier QX Low / Median / High Price $479.48 / $636.32 / $776.67	Professional	QX	$479.48	$636.32	$776.67
Highmark BCBS Facility/Professional Professional Modifier QY Low / Median / High Price $238.35 / $480.70 / $715.00	Professional	QY	$238.35	$480.70	$715.00
Highmark BCBS Facility/Professional Professional Modifier QZ Low / Median / High Price $216.00 / $483.39 / $590.53	Professional	QZ	$216.00	$483.39	$590.53
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $555.00 / $597.00 / $74,999.25	Facility		$555.00	$597.00	$74,999.25
MVP Health Care Facility/Professional Professional Modifier QK Low / Median / High Price $150.00 / $150.00 / $150.00	Professional	QK	$150.00	$150.00	$150.00
MVP Health Care Facility/Professional Professional Modifier QX Low / Median / High Price $150.00 / $150.00 / $150.00	Professional	QX	$150.00	$150.00	$150.00
MVP Health Care Facility/Professional Professional Modifier QY Low / Median / High Price $150.00 / $150.00 / $150.00	Professional	QY	$150.00	$150.00	$150.00
Univera Facility/Professional Facility Modifier Low / Median / High Price $176.00 / $176.00 / $176.00	Facility		$176.00	$176.00	$176.00