Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier AA Low / Median / High Price $457.31 / $457.31 / $457.31	Facility	AA	$457.31	$457.31	$457.31
Aetna Facility/Professional Facility Modifier QK Low / Median / High Price $399.13 / $399.13 / $399.13	Facility	QK	$399.13	$399.13	$399.13
Aetna Facility/Professional Facility Modifier QX Low / Median / High Price $1,105.27 / $1,105.27 / $1,105.27	Facility	QX	$1,105.27	$1,105.27	$1,105.27
Aetna Facility/Professional Facility Modifier QY Low / Median / High Price $392.96 / $392.96 / $392.96	Facility	QY	$392.96	$392.96	$392.96
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $184.36 / $700.00 / $1,120.00	Professional	AA	$184.36	$700.00	$1,120.00
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $462.17 / $496.00 / $511.75	Professional	QZ	$462.17	$496.00	$511.75
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $183.66 / $243.82 / $420.00	Professional	AA	$183.66	$243.82	$420.00
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $140.35 / $140.35 / $160.40	Professional	QZ	$140.35	$140.35	$160.40
Highmark BCBS Facility/Professional Facility Modifier QZ Low / Median / High Price $61.92 / $61.92 / $61.92	Facility	QZ	$61.92	$61.92	$61.92
Highmark BCBS Facility/Professional Professional Modifier AA Low / Median / High Price $283.41 / $551.42 / $891.97	Professional	AA	$283.41	$551.42	$891.97
Highmark BCBS Facility/Professional Professional Modifier QZ Low / Median / High Price $179.30 / $358.61 / $473.62	Professional	QZ	$179.30	$358.61	$473.62
Martin's Point Facility/Professional Facility Modifier AA Low / Median / High Price $457.31 / $457.31 / $457.31	Facility	AA	$457.31	$457.31	$457.31
Martin's Point Facility/Professional Facility Modifier QK Low / Median / High Price $399.13 / $399.13 / $399.13	Facility	QK	$399.13	$399.13	$399.13
Martin's Point Facility/Professional Facility Modifier QX Low / Median / High Price $1,105.27 / $1,105.27 / $1,105.27	Facility	QX	$1,105.27	$1,105.27	$1,105.27
Martin's Point Facility/Professional Facility Modifier QY Low / Median / High Price $392.96 / $392.96 / $392.96	Facility	QY	$392.96	$392.96	$392.96
Martin's Point Facility/Professional Professional Modifier AA Low / Median / High Price $364.25 / $631.09 / $1,120.00	Professional	AA	$364.25	$631.09	$1,120.00
Martin's Point Facility/Professional Professional Modifier QZ Low / Median / High Price $462.17 / $496.00 / $511.75	Professional	QZ	$462.17	$496.00	$511.75