Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $288.40 / $2,187.76 / $6,165.95	Facility		$288.40	$2,187.76	$6,165.95
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $741.31 / $2,630.27 / $5,623.41	Facility	50	$741.31	$2,630.27	$5,623.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $87.10 / $281.84	Professional		$45.71	$87.10	$281.84
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $67.61 / $147.91 / $426.58	Professional	50	$67.61	$147.91	$426.58
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $58.88 / $83.18	Professional		$35.48	$58.88	$83.18
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $57.54 / $91.20 / $123.03	Professional	50	$57.54	$91.20	$123.03
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $1,148.15 / $1,148.15 / $1,202.26	Facility		$1,148.15	$1,148.15	$1,202.26
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $144.54 / $281.84	Professional		$70.79	$144.54	$281.84
AmeriHealth Facility/Professional Professional Modifier 50 Low / Median / High Price $95.50 / $123.03 / $426.58	Professional	50	$95.50	$123.03	$426.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $79.43 / $177.83	Professional		$46.77	$79.43	$177.83
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $89.13 / $436.52	Professional		$58.88	$89.13	$436.52
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 $37.15 / $70.79 / $229.09	Professional		$37.15	$70.79	$229.09
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 $38.02 / $61.66 / $141.25	Professional		$38.02	$61.66	$141.25