Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $104.27 / $2,238.50 / $6,489.00	Facility		$104.27	$2,238.50	$6,489.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,520.08 / $2,714.50 / $4,271.18	Facility	50	$1,520.08	$2,714.50	$4,271.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.41 / $40.74 / $95.84	Professional		$30.41	$40.74	$95.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $26.48 / $27.64 / $31.00	Professional		$26.48	$27.64	$31.00
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $531.25 / $3,182.26 / $8,013.00	Facility		$531.25	$3,182.26	$8,013.00
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $58.29 / $119.25 / $160.00	Professional		$58.29	$119.25	$160.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $36.72 / $36.72 / $39.07	Facility		$36.72	$36.72	$39.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.26 / $57.48 / $125.11	Professional		$31.26	$57.48	$125.11
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $95.82 / $131.47 / $163.07	Professional		$95.82	$131.47	$163.07
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $788.38 / $976.93 / $1,984.08	Facility		$788.38	$976.93	$1,984.08
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $27.07 / $69.90 / $111.44	Professional		$27.07	$69.90	$111.44
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 $33.36 / $85.53 / $156.63	Professional		$33.36	$85.53	$156.63