Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier QK Low / Median / High Price $487.17 / $487.17 / $553.12	Facility	QK	$487.17	$487.17	$553.12
Aetna Facility/Professional Facility Modifier QX Low / Median / High Price $920.49 / $920.49 / $1,820.45	Facility	QX	$920.49	$920.49	$1,820.45
Aetna Facility/Professional Facility Modifier QY Low / Median / High Price $662.52 / $662.52 / $662.52	Facility	QY	$662.52	$662.52	$662.52
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $700.00 / $1,366.80 / $2,380.00	Professional	AA	$700.00	$1,366.80	$2,380.00
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $567.55 / $645.59 / $1,143.58	Professional	QZ	$567.55	$645.59	$1,143.58
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $147.77 / $278.64 / $1,120.00	Professional	AA	$147.77	$278.64	$1,120.00
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $160.40 / $199.70 / $910.00	Professional	QZ	$160.40	$199.70	$910.00
Highmark BCBS Facility/Professional Professional Modifier AA Low / Median / High Price $453.33 / $843.25 / $1,350.00	Professional	AA	$453.33	$843.25	$1,350.00
Highmark BCBS Facility/Professional Professional Modifier QZ Low / Median / High Price $358.60 / $557.07 / $913.41	Professional	QZ	$358.60	$557.07	$913.41
Martin's Point Facility/Professional Facility Modifier QK Low / Median / High Price $487.17 / $487.17 / $553.12	Facility	QK	$487.17	$487.17	$553.12
Martin's Point Facility/Professional Facility Modifier QX Low / Median / High Price $920.49 / $920.49 / $1,820.45	Facility	QX	$920.49	$920.49	$1,820.45
Martin's Point Facility/Professional Facility Modifier QY Low / Median / High Price $662.52 / $662.52 / $662.52	Facility	QY	$662.52	$662.52	$662.52
Martin's Point Facility/Professional Professional Modifier AA Low / Median / High Price $700.00 / $1,120.00 / $2,240.00	Professional	AA	$700.00	$1,120.00	$2,240.00
Martin's Point Facility/Professional Professional Modifier QZ Low / Median / High Price $567.55 / $645.59 / $1,143.58	Professional	QZ	$567.55	$645.59	$1,143.58