Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,137.96 / $4,677.35 / $8,317.64	Facility		$2,137.96	$4,677.35	$8,317.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $645.65 / $3,019.95	Professional		$501.19	$645.65	$3,019.95
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $2,187.76 / $2,187.76 / $2,187.76	Professional	50	$2,187.76	$2,187.76	$2,187.76
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $416.87 / $416.87 / $416.87	Professional	54	$416.87	$416.87	$416.87
CareSource Facility/Professional Facility Modifier Low / Median / High Price $562.34 / $630.96 / $870.96	Facility		$562.34	$630.96	$870.96
CareSource Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $588.84 / $1,174.90	Professional		$489.78	$588.84	$1,174.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $891.25 / $4,168.69	Facility		$891.25	$891.25	$4,168.69
Cigna Facility/Professional Facility Modifier 22 Low / Median / High Price $1,071.52 / $1,071.52 / $1,071.52	Facility	22	$1,071.52	$1,071.52	$1,071.52
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $177.83 / $177.83 / $177.83	Facility	53	$177.83	$177.83	$177.83
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $630.96 / $630.96 / $630.96	Facility	54	$630.96	$630.96	$630.96
Cigna Facility/Professional Facility Modifier 55 Low / Median / High Price $134.90 / $134.90 / $134.90	Facility	55	$134.90	$134.90	$134.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $812.83 / $6,309.57	Professional		$489.78	$812.83	$6,309.57
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,548.13 / $5,623.41 / $9,549.93	Facility		$3,548.13	$5,623.41	$9,549.93
Highmark BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $2,511.89 / $2,511.89 / $2,511.89	Facility	50	$2,511.89	$2,511.89	$2,511.89
Highmark BCBS Facility/Professional Facility Modifier 55 Low / Median / High Price $2,187.76 / $2,187.76 / $2,187.76	Facility	55	$2,187.76	$2,187.76	$2,187.76
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $776.25 / $1,258.93	Professional		$741.31	$776.25	$1,258.93
Highmark BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $1,862.09 / $1,862.09 / $1,862.09	Professional	50	$1,862.09	$1,862.09	$1,862.09
Highmark BCBS Facility/Professional Professional Modifier 54 Low / Median / High Price $512.86 / $562.34 / $870.96	Professional	54	$512.86	$562.34	$870.96
Highmark BCBS Facility/Professional Professional Modifier 55 Low / Median / High Price $144.54 / $251.19 / $251.19	Professional	55	$144.54	$251.19	$251.19
United Facility/Professional Facility Modifier Low / Median / High Price $2,454.71 / $2,454.71 / $6,456.54	Facility		$2,454.71	$2,454.71	$6,456.54
United Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $724.44 / $1,122.02	Professional		$416.87	$724.44	$1,122.02