Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $1,174.90 / $2,290.87 / $3,311.31	Professional	AA	$1,174.90	$2,290.87	$3,311.31
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $1,862.09 / $2,754.23 / $3,311.31	Professional	QZ	$1,862.09	$2,754.23	$3,311.31
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $489.78 / $489.78 / $912.01	Professional	AA	$489.78	$489.78	$912.01
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $239.88 / $239.88 / $239.88	Professional	QZ	$239.88	$239.88	$239.88
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 $141.25 / $316.23 / $467.74	Professional	AA	$141.25	$316.23	$467.74
Geisinger Facility/Professional Professional Modifier QZ Low / Median / High Price $141.25 / $316.23 / $467.74	Professional	QZ	$141.25	$316.23	$467.74
Highmark BCBS Facility/Professional Professional Modifier AA Low / Median / High Price $616.60 / $1,737.80 / $3,388.44	Professional	AA	$616.60	$1,737.80	$3,388.44
Highmark BCBS Facility/Professional Professional Modifier QZ Low / Median / High Price $416.87 / $691.83 / $1,348.96	Professional	QZ	$416.87	$691.83	$1,348.96
Martin's Point Facility/Professional Professional Modifier AA Low / Median / High Price $1,023.29 / $2,290.87 / $3,311.31	Professional	AA	$1,023.29	$2,290.87	$3,311.31
Martin's Point Facility/Professional Professional Modifier QZ Low / Median / High Price $1,862.09 / $2,691.53 / $3,311.31	Professional	QZ	$1,862.09	$2,691.53	$3,311.31