Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $189.05 / $4,118.00 / $9,842.00	Facility		$189.05	$4,118.00	$9,842.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $141.79 / $157.74 / $208.41	Facility	54	$141.79	$157.74	$208.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $175.61 / $210.32 / $372.70	Professional		$175.61	$210.32	$372.70
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $131.71 / $157.74 / $268.45	Professional	54	$131.71	$157.74	$268.45
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $215.61 / $215.61 / $215.61	Professional		$215.61	$215.61	$215.61
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $221.94 / $336.51 / $720.00	Professional		$221.94	$336.51	$720.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $200.74 / $305.85 / $664.53	Professional		$200.74	$305.85	$664.53
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $199.11 / $322.22 / $362.22	Professional		$199.11	$322.22	$362.22
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $486.18 / $583.20 / $1,264.67	Facility		$486.18	$583.20	$1,264.67
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $194.15 / $255.61 / $526.45	Professional		$194.15	$255.61	$526.45
United Facility/Professional Facility Modifier Low / Median / High Price $1,200.00 / $3,339.00 / $9,152.00	Facility		$1,200.00	$3,339.00	$9,152.00
United Facility/Professional Professional Modifier Low / Median / High Price $187.72 / $274.68 / $661.08	Professional		$187.72	$274.68	$661.08