Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $5,541.51 / $15,036.48 / $21,072.87	Facility		$5,541.51	$15,036.48	$21,072.87
Aetna Facility/Professional Facility Modifier 22 Low / Median / High Price $15,880.00 / $15,880.00 / $15,880.00	Facility	22	$15,880.00	$15,880.00	$15,880.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $10,000.00 / $12,900.88 / $18,850.32	Facility	50	$10,000.00	$12,900.88	$18,850.32
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $1,118.86 / $1,118.86 / $1,272.34	Facility	54	$1,118.86	$1,118.86	$1,272.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,214.77 / $1,399.65 / $2,192.96	Professional		$1,214.77	$1,399.65	$2,192.96
Aetna Facility/Professional Professional Modifier AS Low / Median / High Price $148.71 / $148.71 / $148.71	Professional	AS	$148.71	$148.71	$148.71
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $2,183.96 / $2,183.96 / $2,183.96	Professional		$2,183.96	$2,183.96	$2,183.96
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $6,708.00 / $15,000.00 / $22,541.00	Facility		$6,708.00	$15,000.00	$22,541.00
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $1,389.30 / $2,138.29 / $8,356.02	Professional		$1,389.30	$2,138.29	$8,356.02
AmeriHealth Facility/Professional Professional Modifier AS Low / Median / High Price $253.80 / $253.80 / $253.80	Professional	AS	$253.80	$253.80	$253.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $10,500.00 / $15,754.00 / $16,453.00	Facility		$10,500.00	$15,754.00	$16,453.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,293.01 / $1,978.95 / $4,191.93	Professional		$1,293.01	$1,978.95	$4,191.93
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $1,180.83 / $2,014.49 / $2,054.38	Professional		$1,180.83	$2,014.49	$2,054.38
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $9,571.00 / $28,306.58 / $63,531.62	Facility		$9,571.00	$28,306.58	$63,531.62
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,217.18 / $1,635.63 / $3,348.79	Professional		$1,217.18	$1,635.63	$3,348.79
United Facility/Professional Facility Modifier Low / Median / High Price $6,066.00 / $15,296.00 / $27,214.00	Facility		$6,066.00	$15,296.00	$27,214.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,104.45 / $1,729.89 / $5,287.54	Professional		$1,104.45	$1,729.89	$5,287.54