Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $135.90 / $4,294.00 / $9,950.00	Facility		$135.90	$4,294.00	$9,950.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $102.24 / $150.16 / $278.64	Professional		$102.24	$150.16	$278.64
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $167.71 / $167.71 / $167.71	Professional		$167.71	$167.71	$167.71
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $189.00 / $202.05 / $202.05	Professional		$189.00	$202.05	$202.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.09 / $170.52 / $359.32	Professional		$91.09	$170.52	$359.32
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $185.76 / $251.81 / $287.25	Professional		$185.76	$251.81	$287.25
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $402.71 / $483.09 / $921.30	Facility		$402.71	$483.09	$921.30
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $111.98 / $175.72 / $275.35	Professional		$111.98	$175.72	$275.35
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 $104.37 / $182.25 / $356.95	Professional		$104.37	$182.25	$356.95