Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $662.70 / $1,214.18 / $4,513.88	Facility		$662.70	$1,214.18	$4,513.88
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $126.26 / $190.66 / $323.38	Facility	52	$126.26	$190.66	$323.38
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $50.50 / $76.27 / $129.35	Facility	53	$50.50	$76.27	$129.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $244.69 / $402.34 / $615.60	Professional		$244.69	$402.34	$615.60
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $49.56 / $84.58 / $107.27	Professional	53	$49.56	$84.58	$107.27
CareSource Facility/Professional Facility Modifier Low / Median / High Price $238.33 / $286.00 / $371.01	Facility		$238.33	$286.00	$371.01
CareSource Facility/Professional Professional Modifier Low / Median / High Price $404.23 / $641.07 / $955.24	Professional		$404.23	$641.07	$955.24
Cigna Facility/Professional Facility Modifier Low / Median / High Price $426.66 / $426.66 / $426.66	Facility		$426.66	$426.66	$426.66
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $341.33 / $341.33 / $341.33	Facility	52	$341.33	$341.33	$341.33
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $85.33 / $85.33 / $85.33	Facility	53	$85.33	$85.33	$85.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $265.26 / $485.08 / $1,170.86	Professional		$265.26	$485.08	$1,170.86
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $833.26 / $2,463.51 / $5,616.06	Facility		$833.26	$2,463.51	$5,616.06
Highmark BCBS Facility/Professional Facility Modifier 52 Low / Median / High Price $1,697.54 / $1,697.54 / $1,697.54	Facility	52	$1,697.54	$1,697.54	$1,697.54
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $306.88 / $339.30 / $530.37	Professional		$306.88	$339.30	$530.37
Highmark BCBS Facility/Professional Professional Modifier 53 Low / Median / High Price $153.52 / $153.52 / $236.89	Professional	53	$153.52	$153.52	$236.89
United Facility/Professional Facility Modifier Low / Median / High Price $1,225.00 / $1,225.00 / $1,225.00	Facility		$1,225.00	$1,225.00	$1,225.00
United Facility/Professional Professional Modifier Low / Median / High Price $338.22 / $565.91 / $968.24	Professional		$338.22	$565.91	$968.24