Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $355.26 / $4,174.00 / $8,419.00	Facility		$355.26	$4,174.00	$8,419.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,561.78 / $4,606.29 / $8,197.75	Facility	50	$1,561.78	$4,606.29	$8,197.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $187.54 / $355.26 / $556.20	Professional		$187.54	$355.26	$556.20
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $472.25 / $1,269.21 / $2,262.73	Professional	50	$472.25	$1,269.21	$2,262.73
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $150.49 / $150.49 / $150.49	Professional	50	$150.49	$150.49	$150.49
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $1,653.10 / $3,443.23 / $6,790.00	Facility		$1,653.10	$3,443.23	$6,790.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $193.29 / $504.56 / $1,247.68	Professional		$193.29	$504.56	$1,247.68
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $330.07 / $448.83 / $550.45	Professional		$330.07	$448.83	$550.45
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $6,362.84 / $6,362.84 / $13,993.66	Facility		$6,362.84	$6,362.84	$13,993.66
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $141.18 / $278.51 / $528.00	Professional		$141.18	$278.51	$528.00
United Facility/Professional Facility Modifier Low / Median / High Price $4,415.00 / $7,250.00 / $10,536.00	Facility		$4,415.00	$7,250.00	$10,536.00
United Facility/Professional Professional Modifier Low / Median / High Price $223.51 / $335.26 / $748.09	Professional		$223.51	$335.26	$748.09