Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $516.09 / $5,370.43 / $9,006.00	Facility		$516.09	$5,370.43	$9,006.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $3,985.53 / $6,073.00 / $12,121.50	Facility	50	$3,985.53	$6,073.00	$12,121.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $326.87 / $410.84 / $776.06	Professional		$326.87	$410.84	$776.06
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $730.30 / $730.30 / $730.30	Professional		$730.30	$730.30	$730.30
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $9,598.50 / $9,598.50 / $9,598.50	Facility		$9,598.50	$9,598.50	$9,598.50
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $532.00 / $532.00 / $532.00	Professional		$532.00	$532.00	$532.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $352.61 / $651.04 / $1,435.48	Professional		$352.61	$651.04	$1,435.48
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $620.24 / $808.60 / $981.30	Professional		$620.24	$808.60	$981.30
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $7,512.98 / $8,966.36 / $17,754.61	Facility		$7,512.98	$8,966.36	$17,754.61
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $341.23 / $534.11 / $860.47	Professional		$341.23	$534.11	$860.47
United Facility/Professional Facility Modifier Low / Median / High Price $4,415.00 / $7,250.00 / $10,536.00	Facility		$4,415.00	$7,250.00	$10,536.00
United Facility/Professional Professional Modifier Low / Median / High Price $285.02 / $595.95 / $1,106.35	Professional		$285.02	$595.95	$1,106.35