Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,163.27 / $4,643.62 / $8,196.71	Facility		$2,163.27	$4,643.62	$8,196.71
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $108.13 / $108.13 / $108.13	Facility	53	$108.13	$108.13	$108.13
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $405.50 / $405.50 / $405.50	Facility	54	$405.50	$405.50	$405.50
Aetna Facility/Professional Facility Modifier 55 Low / Median / High Price $81.09 / $81.09 / $81.09	Facility	55	$81.09	$81.09	$81.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $540.66 / $658.61 / $1,086.43	Professional		$540.66	$658.61	$1,086.43
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $270.33 / $275.37 / $473.83	Professional	52	$270.33	$275.37	$473.83
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $405.50 / $413.05 / $710.74	Professional	54	$405.50	$413.05	$710.74
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $81.09 / $82.61 / $142.15	Professional	55	$81.09	$82.61	$142.15
CareSource Facility/Professional Facility Modifier Low / Median / High Price $490.94 / $589.13 / $736.41	Facility		$490.94	$589.13	$736.41
CareSource Facility/Professional Professional Modifier Low / Median / High Price $490.94 / $589.13 / $1,138.27	Professional		$490.94	$589.13	$1,138.27
Cigna Facility/Professional Facility Modifier Low / Median / High Price $602.32 / $602.32 / $602.32	Facility		$602.32	$602.32	$602.32
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $120.35 / $120.35 / $120.35	Facility	53	$120.35	$120.35	$120.35
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $421.21 / $421.21 / $421.21	Facility	54	$421.21	$421.21	$421.21
Cigna Facility/Professional Facility Modifier 55 Low / Median / High Price $90.26 / $90.26 / $90.26	Facility	55	$90.26	$90.26	$90.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $522.58 / $711.47 / $6,076.05	Professional		$522.58	$711.47	$6,076.05
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,174.54 / $5,657.68 / $11,373.30	Facility		$3,174.54	$5,657.68	$11,373.30
Highmark BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $2,540.53 / $2,540.53 / $9,568.20	Facility	50	$2,540.53	$2,540.53	$9,568.20
Highmark BCBS Facility/Professional Facility Modifier 55 Low / Median / High Price $2,177.35 / $2,177.35 / $2,177.35	Facility	55	$2,177.35	$2,177.35	$2,177.35
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $751.97 / $784.83 / $1,251.39	Professional		$751.97	$784.83	$1,251.39
Highmark BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $1,867.25 / $1,867.25 / $1,867.25	Professional	50	$1,867.25	$1,867.25	$1,867.25
Highmark BCBS Facility/Professional Professional Modifier 54 Low / Median / High Price $522.13 / $570.66 / $881.03	Professional	54	$522.13	$570.66	$881.03
Highmark BCBS Facility/Professional Professional Modifier 55 Low / Median / High Price $163.05 / $248.97 / $251.73	Professional	55	$163.05	$248.97	$251.73
United Facility/Professional Facility Modifier Low / Median / High Price $2,450.00 / $2,450.00 / $2,450.00	Facility		$2,450.00	$2,450.00	$2,450.00
United Facility/Professional Professional Modifier Low / Median / High Price $418.59 / $640.32 / $1,102.78	Professional		$418.59	$640.32	$1,102.78