Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $770.40 / $806.60 / $1,707.72	Professional	AA	$770.40	$806.60	$1,707.72
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $348.62 / $483.58 / $651.45	Professional	QX	$348.62	$483.58	$651.45
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $347.50 / $502.00 / $502.00	Professional	QY	$347.50	$502.00	$502.00
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $1,007.45 / $1,007.45 / $1,007.45	Professional	QZ	$1,007.45	$1,007.45	$1,007.45
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $390.06 / $390.06 / $390.06	Professional	AA	$390.06	$390.06	$390.06
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $15.30 / $30.61 / $239.64	Professional	QX	$15.30	$30.61	$239.64
Ambetter Facility/Professional Professional Modifier QY Low / Median / High Price $199.70 / $199.70 / $199.70	Professional	QY	$199.70	$199.70	$199.70
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 / $360.00 / $360.00	Professional	QY	$180.00	$360.00	$360.00
Highmark BCBS Facility/Professional Professional Modifier AA Low / Median / High Price $442.63 / $926.66 / $1,482.63	Professional	AA	$442.63	$926.66	$1,482.63
Highmark BCBS Facility/Professional Professional Modifier QX Low / Median / High Price $584.29 / $755.68 / $1,447.93	Professional	QX	$584.29	$755.68	$1,447.93
Highmark BCBS Facility/Professional Professional Modifier QY Low / Median / High Price $954.44 / $954.44 / $954.44	Professional	QY	$954.44	$954.44	$954.44
Highmark BCBS Facility/Professional Professional Modifier QZ Low / Median / High Price $493.92 / $735.54 / $1,014.00	Professional	QZ	$493.92	$735.54	$1,014.00
Martin's Point Facility/Professional Professional Modifier AA Low / Median / High Price $241.98 / $905.25 / $1,896.99	Professional	AA	$241.98	$905.25	$1,896.99
Martin's Point Facility/Professional Professional Modifier QX Low / Median / High Price $169.47 / $483.58 / $691.85	Professional	QX	$169.47	$483.58	$691.85
Martin's Point Facility/Professional Professional Modifier QY Low / Median / High Price $347.50 / $502.00 / $502.00	Professional	QY	$347.50	$502.00	$502.00
Martin's Point Facility/Professional Professional Modifier QZ Low / Median / High Price $1,007.45 / $1,007.45 / $1,007.45	Professional	QZ	$1,007.45	$1,007.45	$1,007.45
Priority Health Facility/Professional Professional Modifier QX Low / Median / High Price $180.00 / $180.00 / $180.00	Professional	QX	$180.00	$180.00	$180.00
Priority Health Facility/Professional Professional Modifier QY Low / Median / High Price $180.00 / $180.00 / $360.00	Professional	QY	$180.00	$180.00	$360.00