Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $103.83 / $2,692.33 / $8,084.00	Facility		$103.83	$2,692.33	$8,084.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,413.06 / $2,915.11 / $8,116.50	Facility	50	$1,413.06	$2,915.11	$8,116.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $66.59 / $150.88 / $255.61	Professional		$66.59	$150.88	$255.61
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $99.92 / $659.15 / $659.15	Professional	50	$99.92	$659.15	$659.15
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $88.93 / $88.93 / $88.93	Professional		$88.93	$88.93	$88.93
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $1,062.40 / $1,062.40 / $1,062.40	Professional		$1,062.40	$1,062.40	$1,062.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $148.41 / $148.41 / $148.41	Facility		$148.41	$148.41	$148.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $82.67 / $188.71 / $456.49	Professional		$82.67	$188.71	$456.49
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 $191.32 / $254.50 / $356.98	Professional		$191.32	$254.50	$356.98
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $160.74 / $338.85	Professional		$74.13	$160.74	$338.85
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 $136.62 / $227.23 / $581.99	Professional		$136.62	$227.23	$581.99