Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $33.81 / $624.00 / $1,168.00	Facility		$33.81	$624.00	$1,168.00
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $563.20 / $1,733.40 / $2,708.10	Professional	AA	$563.20	$1,733.40	$2,708.10
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $404.25 / $739.60 / $989.00	Professional	QK	$404.25	$739.60	$989.00
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $411.95 / $782.60 / $989.00	Professional	QX	$411.95	$782.60	$989.00
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $438.52 / $1,619.90 / $2,037.40	Professional	QZ	$438.52	$1,619.90	$2,037.40
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $561.00 / $612.00 / $1,170.00	Professional	AA	$561.00	$612.00	$1,170.00
Ambetter Facility/Professional Professional Modifier QK Low / Median / High Price $204.92 / $606.82 / $1,232.00	Professional	QK	$204.92	$606.82	$1,232.00
Cigna Facility/Professional Professional Modifier QK Low / Median / High Price $240.00 / $240.00 / $240.00	Professional	QK	$240.00	$240.00	$240.00
Cigna Facility/Professional Professional Modifier QX Low / Median / High Price $240.00 / $240.00 / $240.00	Professional	QX	$240.00	$240.00	$240.00
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $600.00 / $600.00 / $600.00	Facility		$600.00	$600.00	$600.00
Highmark BCBS Facility/Professional Professional Modifier AA Low / Median / High Price $372.00 / $963.26 / $1,364.69	Professional	AA	$372.00	$963.26	$1,364.69
Highmark BCBS Facility/Professional Professional Modifier QK Low / Median / High Price $1,030.20 / $1,146.75 / $1,328.40	Professional	QK	$1,030.20	$1,146.75	$1,328.40
Highmark BCBS Facility/Professional Professional Modifier QX Low / Median / High Price $940.00 / $1,153.30 / $1,357.25	Professional	QX	$940.00	$1,153.30	$1,357.25
Highmark BCBS Facility/Professional Professional Modifier QZ Low / Median / High Price $834.20 / $860.00 / $868.60	Professional	QZ	$834.20	$860.00	$868.60
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $555.00 / $597.00 / $74,999.25	Facility		$555.00	$597.00	$74,999.25
MVP Health Care Facility/Professional Professional Modifier QK Low / Median / High Price $240.00 / $240.00 / $240.00	Professional	QK	$240.00	$240.00	$240.00
MVP Health Care Facility/Professional Professional Modifier QX Low / Median / High Price $240.00 / $240.00 / $240.00	Professional	QX	$240.00	$240.00	$240.00
Univera Facility/Professional Facility Modifier Low / Median / High Price $308.00 / $308.00 / $308.00	Facility		$308.00	$308.00	$308.00