Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,476.78 / $12,910.32 / $20,273.05	Facility		$2,476.78	$12,910.32	$20,273.05
Aetna Facility/Professional Facility Modifier 22 Low / Median / High Price $13,219.32 / $13,219.32 / $15,202.00	Facility	22	$13,219.32	$13,219.32	$15,202.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,391.28 / $15,384.21 / $19,115.00	Facility	50	$2,391.28	$15,384.21	$19,115.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $1,198.77 / $1,198.77 / $1,271.69	Facility	54	$1,198.77	$1,198.77	$1,271.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,243.34 / $1,400.72 / $2,230.25	Professional		$1,243.34	$1,400.72	$2,230.25
Aetna Facility/Professional Professional Modifier AS Low / Median / High Price $181.18 / $181.18 / $181.18	Professional	AS	$181.18	$181.18	$181.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $2,219.92 / $2,219.92 / $2,219.92	Professional		$2,219.92	$2,219.92	$2,219.92
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $4,018.35 / $14,256.00 / $22,541.00	Facility		$4,018.35	$14,256.00	$22,541.00
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $1,387.45 / $2,259.58 / $8,356.02	Professional		$1,387.45	$2,259.58	$8,356.02
AmeriHealth Facility/Professional Professional Modifier AS Low / Median / High Price $258.00 / $258.00 / $269.44	Professional	AS	$258.00	$258.00	$269.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $10,500.00 / $15,104.06 / $21,225.00	Facility		$10,500.00	$15,104.06	$21,225.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,291.61 / $2,033.06 / $4,313.92	Professional		$1,291.61	$2,033.06	$4,313.92
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $1,511.28 / $2,011.80 / $2,307.94	Professional		$1,511.28	$2,011.80	$2,307.94
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $25,244.46 / $28,306.58 / $59,657.57	Facility		$25,244.46	$28,306.58	$59,657.57
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,215.61 / $1,664.54 / $3,005.18	Professional		$1,215.61	$1,664.54	$3,005.18
United Facility/Professional Facility Modifier Low / Median / High Price $6,066.00 / $13,781.00 / $27,214.00	Facility		$6,066.00	$13,781.00	$27,214.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,122.41 / $1,729.42 / $4,257.47	Professional		$1,122.41	$1,729.42	$4,257.47