Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $831.76 / $1,548.82 / $2,238.72	Professional	AA	$831.76	$1,548.82	$2,238.72
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
Geisinger Facility/Professional Professional Modifier AA Low / Median / High Price $93.33 / $213.80 / $309.03	Professional	AA	$93.33	$213.80	$309.03
Geisinger Facility/Professional Professional Modifier QZ Low / Median / High Price $93.33 / $213.80 / $309.03	Professional	QZ	$93.33	$213.80	$309.03
Highmark BCBS Facility/Professional Professional Modifier AA Low / Median / High Price $426.58 / $691.83 / $977.24	Professional	AA	$426.58	$691.83	$977.24
Highmark BCBS Facility/Professional Professional Modifier QZ Low / Median / High Price $478.63 / $537.03 / $602.56	Professional	QZ	$478.63	$537.03	$602.56
Martin's Point Facility/Professional Professional Modifier AA Low / Median / High Price $588.84 / $1,513.56 / $2,238.72	Professional	AA	$588.84	$1,513.56	$2,238.72