Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $59.78 / $3,259.00 / $9,125.00	Facility		$59.78	$3,259.00	$9,125.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $637.25 / $637.25 / $1,060.00	Facility	50	$637.25	$637.25	$1,060.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.91 / $69.53 / $130.07	Professional		$51.91	$69.53	$130.07
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $523.50 / $523.50 / $523.50	Professional	50	$523.50	$523.50	$523.50
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $116.60 / $116.60 / $116.60	Professional	50	$116.60	$116.60	$116.60
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $121.69 / $208.77 / $320.00	Professional		$121.69	$208.77	$320.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $60.12 / $98.95 / $216.13	Professional		$60.12	$98.95	$216.13
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $8,161.00 / $8,161.00 / $8,161.00	Facility		$8,161.00	$8,161.00	$8,161.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $75.31 / $119.74 / $131.62	Professional		$75.31	$119.74	$131.62
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $598.27 / $717.67 / $1,556.24	Facility		$598.27	$717.67	$1,556.24
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $53.46 / $83.28 / $162.69	Professional		$53.46	$83.28	$162.69
United Facility/Professional Facility Modifier Low / Median / High Price $1,241.44 / $3,339.00 / $9,152.00	Facility		$1,241.44	$3,339.00	$9,152.00
United Facility/Professional Professional Modifier Low / Median / High Price $65.53 / $98.16 / $257.61	Professional		$65.53	$98.16	$257.61