Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $109.65 / $758.58 / $1,174.90	Professional	AA	$109.65	$758.58	$1,174.90
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $269.15 / $398.11 / $537.03	Professional	QX	$269.15	$398.11	$537.03
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $269.15 / $398.11 / $489.78	Professional	QY	$269.15	$398.11	$489.78
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $72.44 / $269.15 / $616.60	Professional	QZ	$72.44	$269.15	$616.60
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $194.98 / $194.98 / $194.98	Professional	QX	$194.98	$194.98	$194.98
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
Highmark BCBS Facility/Professional Professional Modifier AA Low / Median / High Price $407.38 / $407.38 / $707.95	Professional	AA	$407.38	$407.38	$707.95
Highmark BCBS Facility/Professional Professional Modifier QX Low / Median / High Price $398.11 / $436.52 / $794.33	Professional	QX	$398.11	$436.52	$794.33
Highmark BCBS Facility/Professional Professional Modifier QY Low / Median / High Price $380.19 / $380.19 / $407.38	Professional	QY	$380.19	$380.19	$407.38