Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $113.93 / $2,782.87 / $6,331.13	Facility		$113.93	$2,782.87	$6,331.13
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $682.84 / $5,442.69 / $5,843.00	Facility	50	$682.84	$5,442.69	$5,843.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $55.86 / $87.33 / $161.53	Professional		$55.86	$87.33	$161.53
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $151.29 / $180.45 / $304.36	Professional	50	$151.29	$180.45	$304.36
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $92.34 / $104.14 / $166.62	Professional		$92.34	$104.14	$166.62
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $531.25 / $5,222.30 / $8,013.00	Facility		$531.25	$5,222.30	$8,013.00
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $90.30 / $154.32 / $257.63	Professional		$90.30	$154.32	$257.63
AmeriHealth Facility/Professional Professional Modifier 50 Low / Median / High Price $164.61 / $164.61 / $164.61	Professional	50	$164.61	$164.61	$164.61
Cigna Facility/Professional Facility Modifier Low / Median / High Price $370.08 / $370.08 / $370.08	Facility		$370.08	$370.08	$370.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $64.02 / $116.21 / $255.71	Professional		$64.02	$116.21	$255.71
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 $89.97 / $155.10 / $157.18	Professional		$89.97	$155.10	$157.18
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $598.27 / $657.72 / $717.67	Facility		$598.27	$657.72	$717.67
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $55.90 / $99.35 / $191.32	Professional		$55.90	$99.35	$191.32
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 $81.95 / $125.90 / $267.88	Professional		$81.95	$125.90	$267.88