Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $245.00 / $432.00 / $432.00	Facility		$245.00	$432.00	$432.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $22.83 / $91.31 / $213.05	Facility		$22.83	$91.31	$213.05
Highmark BCBS Facility/Professional Professional Modifier QX Low / Median / High Price $1,281.00 / $1,281.00 / $1,281.00	Professional	QX	$1,281.00	$1,281.00	$1,281.00
Highmark BCBS Facility/Professional Professional Modifier QZ Low / Median / High Price $350.88 / $350.88 / $514.63	Professional	QZ	$350.88	$350.88	$514.63