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 Facility Modifier QZ Low / Median / High Price $614.97 / $614.97 / $614.97	Facility	QZ	$614.97	$614.97	$614.97
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $244.00 / $700.00 / $1,362.90	Professional	AA	$244.00	$700.00	$1,362.90
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $270.30 / $517.70 / $713.80	Professional	QK	$270.30	$517.70	$713.80
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $355.20 / $559.00 / $731.00	Professional	QX	$355.20	$559.00	$731.00
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $455.80 / $533.20 / $693.05	Professional	QY	$455.80	$533.20	$693.05
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $262.25 / $968.60 / $1,285.90	Professional	QZ	$262.25	$968.60	$1,285.90
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $106.65 / $160.72 / $455.00	Professional	AA	$106.65	$160.72	$455.00
Ambetter Facility/Professional Professional Modifier QK Low / Median / High Price $50.23 / $60.27 / $275.83	Professional	QK	$50.23	$60.27	$275.83
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $51.20 / $60.18 / $551.65	Professional	QX	$51.20	$60.18	$551.65
Ambetter Facility/Professional Professional Modifier QY Low / Median / High Price $330.99 / $330.99 / $392.00	Professional	QY	$330.99	$330.99	$392.00
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $100.45 / $100.45 / $133.40	Professional	QZ	$100.45	$100.45	$133.40
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 $300.00 / $300.00 / $300.00	Facility		$300.00	$300.00	$300.00
Fidelis Facility/Professional Professional Modifier AA Low / Median / High Price $7.91 / $7.91 / $7.91	Professional	AA	$7.91	$7.91	$7.91
Highmark BCBS Facility/Professional Professional Modifier AA Low / Median / High Price $171.62 / $441.60 / $556.79	Professional	AA	$171.62	$441.60	$556.79
Highmark BCBS Facility/Professional Professional Modifier QK Low / Median / High Price $190.00 / $505.00 / $619.66	Professional	QK	$190.00	$505.00	$619.66
Highmark BCBS Facility/Professional Professional Modifier QX Low / Median / High Price $392.53 / $516.04 / $639.52	Professional	QX	$392.53	$516.04	$639.52
Highmark BCBS Facility/Professional Professional Modifier QY Low / Median / High Price $207.20 / $409.50 / $555.75	Professional	QY	$207.20	$409.50	$555.75
Highmark BCBS Facility/Professional Professional Modifier QZ Low / Median / High Price $146.19 / $373.90 / $473.00	Professional	QZ	$146.19	$373.90	$473.00
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