Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier AA Low / Median / High Price $666.85 / $666.85 / $666.85	Facility	AA	$666.85	$666.85	$666.85
Aetna Facility/Professional Facility Modifier QK Low / Median / High Price $211.30 / $252.85 / $488.23	Facility	QK	$211.30	$252.85	$488.23
Aetna Facility/Professional Facility Modifier QX Low / Median / High Price $633.20 / $682.67 / $889.38	Facility	QX	$633.20	$682.67	$889.38
Aetna Facility/Professional Facility Modifier QY Low / Median / High Price $399.13 / $476.32 / $487.70	Facility	QY	$399.13	$476.32	$487.70
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $575.69 / $840.00 / $1,524.60	Professional	AA	$575.69	$840.00	$1,524.60
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $546.20 / $584.15 / $680.64	Professional	QZ	$546.20	$584.15	$680.64
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $194.21 / $348.32 / $480.00	Professional	AA	$194.21	$348.32	$480.00
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $180.45 / $180.45 / $483.00	Professional	QZ	$180.45	$180.45	$483.00
Highmark BCBS Facility/Professional Professional Modifier AA Low / Median / High Price $340.20 / $514.22 / $926.66	Professional	AA	$340.20	$514.22	$926.66
Highmark BCBS Facility/Professional Professional Modifier QZ Low / Median / High Price $232.20 / $407.95 / $659.69	Professional	QZ	$232.20	$407.95	$659.69
Martin's Point Facility/Professional Facility Modifier AA Low / Median / High Price $666.85 / $666.85 / $666.85	Facility	AA	$666.85	$666.85	$666.85
Martin's Point Facility/Professional Facility Modifier QK Low / Median / High Price $211.30 / $252.85 / $488.23	Facility	QK	$211.30	$252.85	$488.23
Martin's Point Facility/Professional Facility Modifier QX Low / Median / High Price $633.20 / $682.67 / $889.38	Facility	QX	$633.20	$682.67	$889.38
Martin's Point Facility/Professional Facility Modifier QY Low / Median / High Price $399.13 / $476.32 / $487.70	Facility	QY	$399.13	$476.32	$487.70
Martin's Point Facility/Professional Professional Modifier AA Low / Median / High Price $543.24 / $764.67 / $1,530.00	Professional	AA	$543.24	$764.67	$1,530.00
Martin's Point Facility/Professional Professional Modifier QZ Low / Median / High Price $546.20 / $601.09 / $680.64	Professional	QZ	$546.20	$601.09	$680.64