Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $43.29 / $2,017.35 / $8,084.00	Facility		$43.29	$2,017.35	$8,084.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $629.22 / $2,428.55 / $6,481.00	Facility	50	$629.22	$2,428.55	$6,481.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.21 / $55.01 / $93.40	Professional		$37.21	$55.01	$93.40
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $376.50 / $376.50 / $376.50	Professional	50	$376.50	$376.50	$376.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $51.42 / $59.30 / $63.98	Professional		$51.42	$59.30	$63.98
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $80.33 / $80.33 / $80.33	Professional	50	$80.33	$80.33	$80.33
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $50.50 / $86.85 / $161.32	Professional		$50.50	$86.85	$161.32
AmeriHealth Facility/Professional Professional Modifier 50 Low / Median / High Price $82.85 / $153.00 / $168.00	Professional	50	$82.85	$153.00	$168.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.09 / $71.08 / $154.35	Professional		$42.09	$71.08	$154.35
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 $67.84 / $90.65 / $91.74	Professional		$67.84	$90.65	$91.74
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $717.67 / $717.67 / $1,368.67	Facility		$717.67	$717.67	$1,368.67
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.10 / $57.53 / $118.47	Professional		$33.10	$57.53	$118.47
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 $47.46 / $70.02 / $166.33	Professional		$47.46	$70.02	$166.33