Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $869.87 / $5,215.00 / $10,871.00	Facility		$869.87	$5,215.00	$10,871.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $3,721.90 / $6,856.16 / $9,346.50	Facility	50	$3,721.90	$6,856.16	$9,346.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $297.81 / $654.98 / $2,185.06	Professional		$297.81	$654.98	$2,185.06
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $331.99 / $2,332.66 / $6,015.33	Professional	50	$331.99	$2,332.66	$6,015.33
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $135.58 / $269.72 / $638.99	Professional		$135.58	$269.72	$638.99
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $209.54 / $890.31 / $1,134.61	Professional	50	$209.54	$890.31	$1,134.61
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $2,171.30 / $4,522.57 / $5,628.64	Facility		$2,171.30	$4,522.57	$5,628.64
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $197.10 / $3,612.00 / $3,612.00	Professional		$197.10	$3,612.00	$3,612.00
AmeriHealth Facility/Professional Professional Modifier 50 Low / Median / High Price $207.49 / $207.49 / $207.49	Professional	50	$207.49	$207.49	$207.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $335.96 / $335.96 / $342.03	Facility		$335.96	$335.96	$342.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $312.51 / $819.14 / $3,026.81	Professional		$312.51	$819.14	$3,026.81
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $1,586.24 / $2,188.63 / $2,712.71	Professional		$1,586.24	$2,188.63	$2,712.71
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $242.26 / $1,105.48 / $2,478.86	Professional		$242.26	$1,105.48	$2,478.86
United Facility/Professional Facility Modifier Low / Median / High Price $1,516.00 / $3,352.00 / $10,536.00	Facility		$1,516.00	$3,352.00	$10,536.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,123.98 / $1,821.15 / $3,732.86	Professional		$1,123.98	$1,821.15	$3,732.86