Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $816.86 / $2,768.50 / $4,049.52	Facility		$816.86	$2,768.50	$4,049.52
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,408.12 / $5,537.00 / $6,816.88	Facility	50	$1,408.12	$5,537.00	$6,816.88
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $20.16 / $33.21 / $68.63	Facility	53	$20.16	$33.21	$68.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $100.78 / $216.21 / $278.32	Professional		$100.78	$216.21	$278.32
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $342.12 / $350.22 / $354.08	Professional	50	$342.12	$350.22	$354.08
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $20.16 / $42.71 / $71.39	Professional	53	$20.16	$42.71	$71.39
CareSource Facility/Professional Facility Modifier Low / Median / High Price $103.77 / $124.52 / $171.22	Facility		$103.77	$124.52	$171.22
CareSource Facility/Professional Professional Modifier Low / Median / High Price $214.46 / $343.14 / $497.23	Professional		$214.46	$343.14	$497.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $188.07 / $188.07 / $188.07	Facility		$188.07	$188.07	$188.07
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $37.61 / $37.61 / $37.61	Facility	53	$37.61	$37.61	$37.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $245.28 / $565.52	Professional		$117.49	$245.28	$565.52
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,476.49 / $3,009.59 / $4,799.84	Facility		$1,476.49	$3,009.59	$4,799.84
Highmark BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $1,409.84 / $3,602.01 / $6,415.29	Facility	50	$1,409.84	$3,602.01	$6,415.29
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $147.47 / $166.16 / $169.25	Professional		$147.47	$166.16	$169.25
Highmark BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $253.87 / $253.87 / $253.87	Professional	50	$253.87	$253.87	$253.87
United Facility/Professional Professional Modifier Low / Median / High Price $176.39 / $317.82 / $561.90	Professional		$176.39	$317.82	$561.90
United Facility/Professional Professional Modifier 50 Low / Median / High Price $450.22 / $450.22 / $450.22	Professional	50	$450.22	$450.22	$450.22