Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,346.50 / $5,644.00 / $10,202.00	Facility		$1,346.50	$5,644.00	$10,202.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,911.00 / $5,916.75 / $9,096.00	Facility	50	$2,911.00	$5,916.75	$9,096.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $312.25 / $1,174.73 / $2,439.19	Professional		$312.25	$1,174.73	$2,439.19
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $216.72 / $857.46 / $2,710.34	Professional	50	$216.72	$857.46	$2,710.34
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $135.96 / $253.11 / $324.06	Professional		$135.96	$253.11	$324.06
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $259.10 / $263.49 / $1,118.02	Professional	50	$259.10	$263.49	$1,118.02
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $312.67 / $312.67 / $312.67	Professional		$312.67	$312.67	$312.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $370.21 / $1,013.40 / $3,452.72	Professional		$370.21	$1,013.40	$3,452.72
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $2,312.01 / $3,188.62 / $3,977.55	Professional		$2,312.01	$3,188.62	$3,977.55
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $12,657.58 / $13,142.33 / $23,325.32	Facility		$12,657.58	$13,142.33	$23,325.32
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $285.92 / $1,811.25 / $2,992.17	Professional		$285.92	$1,811.25	$2,992.17
United Facility/Professional Facility Modifier Low / Median / High Price $4,881.00 / $10,536.00 / $23,291.00	Facility		$4,881.00	$10,536.00	$23,291.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,790.69 / $2,291.51 / $4,560.43	Professional		$1,790.69	$2,291.51	$4,560.43