Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $758.58 / $2,290.87 / $5,128.61	Facility		$758.58	$2,290.87	$5,128.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $426.58 / $912.01	Professional		$194.98	$426.58	$912.01
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $181.97 / $275.42 / $831.76	Professional	52	$181.97	$275.42	$831.76
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $97.72 / $144.54 / $234.42	Professional	53	$97.72	$144.54	$234.42
CareSource Facility/Professional Facility Modifier Low / Median / High Price $194.98 / $245.47 / $338.84	Facility		$194.98	$245.47	$338.84
CareSource Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $457.09 / $933.25	Professional		$380.19	$457.09	$933.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $338.84 / $338.84 / $338.84	Facility		$338.84	$338.84	$338.84
Cigna Facility/Professional Facility Modifier 22 Low / Median / High Price $407.38 / $407.38 / $407.38	Facility	22	$407.38	$407.38	$407.38
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $269.15 / $269.15 / $269.15	Facility	52	$269.15	$269.15	$269.15
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $67.61 / $67.61 / $67.61	Facility	53	$67.61	$67.61	$67.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $446.68 / $1,318.26	Professional		$208.93	$446.68	$1,318.26
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,122.02 / $2,454.71 / $6,606.93	Facility		$1,122.02	$2,454.71	$6,606.93
Highmark BCBS Facility/Professional Facility Modifier 52 Low / Median / High Price $645.65 / $645.65 / $3,019.95	Facility	52	$645.65	$645.65	$3,019.95
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $239.88 / $478.63	Professional		$218.78	$239.88	$478.63
Highmark BCBS Facility/Professional Professional Modifier 52 Low / Median / High Price $120.23 / $186.21 / $190.55	Professional	52	$120.23	$186.21	$190.55
Highmark BCBS Facility/Professional Professional Modifier 53 Low / Median / High Price $120.23 / $120.23 / $120.23	Professional	53	$120.23	$120.23	$120.23
United Facility/Professional Facility Modifier Low / Median / High Price $1,230.27 / $1,230.27 / $3,311.31	Facility		$1,230.27	$1,230.27	$3,311.31
United Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $380.19 / $724.44	Professional		$186.21	$380.19	$724.44