Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $3,311.31 / $10,000.00	Facility		$223.87	$3,311.31	$10,000.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,884.03 / $5,623.41 / $9,120.11	Facility	50	$2,884.03	$5,623.41	$9,120.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $74.13 / $251.19	Professional		$37.15	$74.13	$251.19
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $75.86 / $141.25 / $398.11	Professional	50	$75.86	$141.25	$398.11
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $50.12 / $61.66	Professional		$31.62	$50.12	$61.66
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $97.72 / $97.72 / $100.00	Professional	50	$97.72	$97.72	$100.00
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $1,096.48 / $1,096.48 / $1,096.48	Facility		$1,096.48	$1,096.48	$1,096.48
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $93.33 / $181.97	Professional		$26.92	$93.33	$181.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $66.07 / $144.54	Professional		$38.90	$66.07	$144.54
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $70.79 / $97.72	Professional		$48.98	$70.79	$97.72
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $602.56 / $954.99 / $1,513.56	Facility		$602.56	$954.99	$1,513.56
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $60.26 / $151.36	Professional		$30.20	$60.26	$151.36
United Facility/Professional Facility Modifier Low / Median / High Price $1,318.26 / $2,884.03 / $7,762.47	Facility		$1,318.26	$2,884.03	$7,762.47
United Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $51.29 / $117.49	Professional		$31.62	$51.29	$117.49