Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $10.23 / $912.01 / $1,348.96	Facility		$10.23	$912.01	$1,348.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $363.08 / $616.60	Professional		$275.42	$363.08	$616.60
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $478.63 / $870.96 / $933.25	Professional	50	$478.63	$870.96	$933.25
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $338.84 / $338.84 / $338.84	Professional	54	$338.84	$338.84	$338.84
CareSource Facility/Professional Facility Modifier Low / Median / High Price $316.23 / $354.81 / $501.19	Facility		$316.23	$354.81	$501.19
CareSource Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $331.13 / $707.95	Professional		$295.12	$331.13	$707.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $512.86 / $512.86 / $1,862.09	Facility		$512.86	$512.86	$1,862.09
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $354.81 / $354.81 / $354.81	Facility	54	$354.81	$354.81	$354.81
Cigna Facility/Professional Facility Modifier 55 Low / Median / High Price $75.86 / $75.86 / $75.86	Facility	55	$75.86	$75.86	$75.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $371.54 / $1,548.82	Professional		$257.04	$371.54	$1,548.82
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $741.31 / $1,513.56 / $2,290.87	Facility		$741.31	$1,513.56	$2,290.87
Highmark BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $2,041.74 / $2,041.74 / $2,089.30	Facility	50	$2,041.74	$2,041.74	$2,089.30
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $467.74 / $707.95	Professional		$416.87	$467.74	$707.95
Highmark BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $676.08 / $758.58 / $1,096.48	Professional	50	$676.08	$758.58	$1,096.48
Highmark BCBS Facility/Professional Professional Modifier 54 Low / Median / High Price $323.59 / $489.78 / $588.84	Professional	54	$323.59	$489.78	$588.84
United Facility/Professional Facility Modifier Low / Median / High Price $691.83 / $691.83 / $1,548.82	Facility		$691.83	$691.83	$1,548.82
United Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $295.12 / $524.81	Professional		$229.09	$295.12	$524.81