Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $323.14 / $955.50 / $1,805.40	Professional	AA	$323.14	$955.50	$1,805.40
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $358.05 / $636.40 / $867.30	Professional	QK	$358.05	$636.40	$867.30
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $361.90 / $654.90 / $868.60	Professional	QX	$361.90	$654.90	$868.60
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $388.85 / $679.40 / $835.00	Professional	QY	$388.85	$679.40	$835.00
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $350.82 / $1,290.00 / $1,691.50	Professional	QZ	$350.82	$1,290.00	$1,691.50
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $204.80 / $455.00 / $882.64	Professional	AA	$204.80	$455.00	$882.64
Ambetter Facility/Professional Professional Modifier QK Low / Median / High Price $81.97 / $255.00 / $517.50	Professional	QK	$81.97	$255.00	$517.50
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $80.23 / $81.92 / $882.64	Professional	QX	$80.23	$81.92	$882.64
Ambetter Facility/Professional Professional Modifier QY Low / Median / High Price $84.38 / $98.73 / $229.50	Professional	QY	$84.38	$98.73	$229.50
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $184.32 / $213.44 / $408.00	Professional	QZ	$184.32	$213.44	$408.00
Cigna Facility/Professional Professional Modifier QK Low / Median / High Price $180.00 / $180.00 / $180.00	Professional	QK	$180.00	$180.00	$180.00
Cigna Facility/Professional Professional Modifier QX Low / Median / High Price $180.00 / $180.00 / $180.00	Professional	QX	$180.00	$180.00	$180.00
Cigna Facility/Professional Professional Modifier QY Low / Median / High Price $180.00 / $180.00 / $180.00	Professional	QY	$180.00	$180.00	$180.00
Highmark BCBS Facility/Professional Professional Modifier AA Low / Median / High Price $284.00 / $724.54 / $961.83	Professional	AA	$284.00	$724.54	$961.83
Highmark BCBS Facility/Professional Professional Modifier QK Low / Median / High Price $619.60 / $813.16 / $1,035.00	Professional	QK	$619.60	$813.16	$1,035.00
Highmark BCBS Facility/Professional Professional Modifier QX Low / Median / High Price $607.20 / $787.09 / $972.00	Professional	QX	$607.20	$787.09	$972.00
Highmark BCBS Facility/Professional Professional Modifier QY Low / Median / High Price $310.67 / $773.33 / $990.00	Professional	QY	$310.67	$773.33	$990.00
Highmark BCBS Facility/Professional Professional Modifier QZ Low / Median / High Price $224.06 / $557.60 / $687.43	Professional	QZ	$224.06	$557.60	$687.43
MVP Health Care Facility/Professional Professional Modifier QK Low / Median / High Price $180.00 / $180.00 / $180.00	Professional	QK	$180.00	$180.00	$180.00
MVP Health Care Facility/Professional Professional Modifier QX Low / Median / High Price $180.00 / $180.00 / $180.00	Professional	QX	$180.00	$180.00	$180.00
MVP Health Care Facility/Professional Professional Modifier QY Low / Median / High Price $180.00 / $180.00 / $180.00	Professional	QY	$180.00	$180.00	$180.00