Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,951.21 / $12,022.64 / $25,118.86	Facility		$2,951.21	$12,022.64	$25,118.86
Aetna Facility/Professional Facility Modifier 22 Low / Median / High Price $13,182.57 / $13,182.57 / $15,135.61	Facility	22	$13,182.57	$13,182.57	$15,135.61
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,511.89 / $15,135.61 / $19,054.61	Facility	50	$2,511.89	$15,135.61	$19,054.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $1,905.46 / $17,782.79	Professional		$776.25	$1,905.46	$17,782.79
Aetna Facility/Professional Professional Modifier AS Low / Median / High Price $169.82 / $338.84 / $891.25	Professional	AS	$169.82	$338.84	$891.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $1,148.15 / $1,584.89	Professional		$141.25	$1,148.15	$1,584.89
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $15,488.17 / $15,488.17 / $15,488.17	Facility		$15,488.17	$15,488.17	$15,488.17
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $1,380.38 / $5,128.61 / $12,589.25	Professional		$1,380.38	$5,128.61	$12,589.25
AmeriHealth Facility/Professional Professional Modifier AS Low / Median / High Price $257.04 / $257.04 / $269.15	Professional	AS	$257.04	$257.04	$269.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $8,317.64 / $16,595.87 / $21,379.62	Facility		$8,317.64	$16,595.87	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,230.27 / $1,995.26 / $4,168.69	Professional		$1,230.27	$1,995.26	$4,168.69
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $1,174.90 / $1,445.44 / $1,995.26	Professional		$1,174.90	$1,445.44	$1,995.26
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $10,715.19 / $35,481.34 / $61,659.50	Facility		$10,715.19	$35,481.34	$61,659.50
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,202.26 / $1,778.28 / $5,495.41	Professional		$1,202.26	$1,778.28	$5,495.41
United Facility/Professional Facility Modifier Low / Median / High Price $5,128.61 / $12,302.69 / $29,512.09	Facility		$5,128.61	$12,302.69	$29,512.09
United Facility/Professional Professional Modifier Low / Median / High Price $1,023.29 / $1,479.11 / $3,548.13	Professional		$1,023.29	$1,479.11	$3,548.13