Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $316.23 / $1,584.89 / $2,818.38	Professional	AA	$316.23	$1,584.89	$2,818.38
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $128.82 / $954.99 / $2,691.53	Professional	QZ	$128.82	$954.99	$2,691.53
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $141.25 / $162.18 / $524.81	Professional	QZ	$141.25	$162.18	$524.81
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 $478.63 / $537.03 / $1,380.38	Professional	AA	$478.63	$537.03	$1,380.38
Highmark BCBS Facility/Professional Professional Modifier QZ Low / Median / High Price $363.08 / $741.31 / $1,000.00	Professional	QZ	$363.08	$741.31	$1,000.00
Martin's Point Facility/Professional Professional Modifier AA Low / Median / High Price $204.17 / $1,778.28 / $2,818.38	Professional	AA	$204.17	$1,778.28	$2,818.38
Martin's Point Facility/Professional Professional Modifier QZ Low / Median / High Price $128.82 / $933.25 / $2,691.53	Professional	QZ	$128.82	$933.25	$2,691.53