Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $143.13 / $1,332.00 / $6,872.00	Facility		$143.13	$1,332.00	$6,872.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $95.15 / $107.36 / $193.66	Facility	54	$95.15	$107.36	$193.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $136.69 / $175.83 / $639.13	Professional		$136.69	$175.83	$639.13
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $198.87 / $198.87 / $198.87	Professional		$198.87	$198.87	$198.87
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $175.96 / $234.61 / $329.93	Professional		$175.96	$234.61	$329.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $148.41 / $221.54 / $445.49	Professional		$148.41	$221.54	$445.49
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $221.55 / $300.33 / $339.62	Professional		$221.55	$300.33	$339.62
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $971.34 / $1,723.95 / $1,972.74	Facility		$971.34	$1,723.95	$1,972.74
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $171.45 / $223.99 / $312.23	Professional		$171.45	$223.99	$312.23
United Facility/Professional Facility Modifier Low / Median / High Price $1,529.00 / $3,352.00 / $10,536.00	Facility		$1,529.00	$3,352.00	$10,536.00
United Facility/Professional Professional Modifier Low / Median / High Price $119.23 / $198.21 / $399.30	Professional		$119.23	$198.21	$399.30