Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $239.88 / $1,047.13 / $1,737.80	Professional	AA	$239.88	$1,047.13	$1,737.80
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $295.12 / $478.63 / $794.33	Professional	QK	$295.12	$478.63	$794.33
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $302.00 / $478.63 / $812.83	Professional	QX	$302.00	$478.63	$812.83
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $331.13 / $489.78 / $812.83	Professional	QY	$331.13	$489.78	$812.83
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $457.09 / $891.25 / $1,621.81	Professional	QZ	$457.09	$891.25	$1,621.81
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $154.88 / $154.88 / $158.49	Professional	AA	$154.88	$154.88	$158.49
Ambetter Facility/Professional Professional Modifier QK Low / Median / High Price $229.09 / $229.09 / $549.54	Professional	QK	$229.09	$229.09	$549.54
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $81.28 / $104.71 / $549.54	Professional	QX	$81.28	$104.71	$549.54
Ambetter Facility/Professional Professional Modifier QY Low / Median / High Price $380.19 / $380.19 / $380.19	Professional	QY	$380.19	$380.19	$380.19
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $138.04 / $162.18 / $870.96	Professional	QZ	$138.04	$162.18	$870.96
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
Highmark BCBS Facility/Professional Professional Modifier AA Low / Median / High Price $309.03 / $741.31 / $933.25	Professional	AA	$309.03	$741.31	$933.25
Highmark BCBS Facility/Professional Professional Modifier QK Low / Median / High Price $630.96 / $812.83 / $1,023.29	Professional	QK	$630.96	$812.83	$1,023.29
Highmark BCBS Facility/Professional Professional Modifier QX Low / Median / High Price $616.60 / $776.25 / $954.99	Professional	QX	$616.60	$776.25	$954.99
Highmark BCBS Facility/Professional Professional Modifier QY Low / Median / High Price $467.74 / $676.08 / $954.99	Professional	QY	$467.74	$676.08	$954.99
Highmark BCBS Facility/Professional Professional Modifier QZ Low / Median / High Price $239.88 / $575.44 / $691.83	Professional	QZ	$239.88	$575.44	$691.83