Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $169.77 / $3,225.00 / $9,784.00	Facility		$169.77	$3,225.00	$9,784.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $127.33 / $139.69 / $187.54	Facility	54	$127.33	$139.69	$187.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $162.06 / $188.87 / $346.72	Professional		$162.06	$188.87	$346.72
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $122.99 / $143.66 / $237.54	Professional	54	$122.99	$143.66	$237.54
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $226.27 / $226.27 / $303.00	Professional		$226.27	$226.27	$303.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $184.63 / $275.08 / $595.26	Professional		$184.63	$275.08	$595.26
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $185.46 / $278.87 / $342.79	Professional		$185.46	$278.87	$342.79
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $561.69 / $583.20 / $1,112.21	Facility		$561.69	$583.20	$1,112.21
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $176.57 / $231.08 / $462.09	Professional		$176.57	$231.08	$462.09
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 $164.37 / $242.63 / $572.11	Professional		$164.37	$242.63	$572.11