Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $7,404.30 / $22,531.80 / $38,397.12	Facility		$7,404.30	$22,531.80	$38,397.12
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $954.29 / $954.29 / $1,480.50	Facility	54	$954.29	$954.29	$1,480.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $329.66 / $1,449.74 / $2,788.27	Professional		$329.66	$1,449.74	$2,788.27
Aetna Facility/Professional Professional Modifier AS Low / Median / High Price $172.17 / $333.11 / $340.65	Professional	AS	$172.17	$333.11	$340.65
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,233.75 / $1,480.50 / $1,850.63	Facility		$1,233.75	$1,480.50	$1,850.63
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,233.75 / $1,850.63 / $2,860.52	Professional		$1,233.75	$1,850.63	$2,860.52
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,455.37 / $1,455.37 / $1,455.37	Facility		$1,455.37	$1,455.37	$1,455.37
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $1,008.15 / $1,008.15 / $1,008.15	Facility	54	$1,008.15	$1,008.15	$1,008.15
Cigna Facility/Professional Facility Modifier 62 Low / Median / High Price $900.13 / $900.13 / $900.13	Facility	62	$900.13	$900.13	$900.13
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $144.02 / $144.02 / $144.02	Facility	AS	$144.02	$144.02	$144.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,239.39 / $1,955.58 / $3,924.63	Professional		$1,239.39	$1,955.58	$3,924.63
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $15,590.35 / $36,010.51 / $59,565.58	Facility		$15,590.35	$36,010.51	$59,565.58
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,824.58 / $1,917.44 / $2,932.77	Professional		$1,824.58	$1,917.44	$2,932.77
Highmark BCBS Facility/Professional Professional Modifier AS Low / Median / High Price $248.97 / $248.97 / $248.97	Professional	AS	$248.97	$248.97	$248.97
United Facility/Professional Professional Modifier Low / Median / High Price $1,102.00 / $1,639.23 / $2,248.94	Professional		$1,102.00	$1,639.23	$2,248.94