Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $371.54 / $2,137.96 / $7,079.46	Facility		$371.54	$2,137.96	$7,079.46
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,513.56 / $2,818.38 / $4,265.80	Facility	50	$1,513.56	$2,818.38	$4,265.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $60.26 / $169.82	Professional		$30.20	$60.26	$169.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $16.60 / $30.90 / $56.23	Professional		$16.60	$30.90	$56.23
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $309.03 / $309.03 / $630.96	Facility		$309.03	$309.03	$630.96
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $120.23 / $158.49	Professional		$58.88	$120.23	$158.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $36.31 / $36.31 / $38.90	Facility		$36.31	$36.31	$38.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $60.26 / $144.54	Professional		$32.36	$60.26	$144.54
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $134.90 / $165.96	Professional		$97.72	$134.90	$165.96
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $812.83 / $1,288.25 / $2,041.74	Facility		$812.83	$1,288.25	$2,041.74
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $75.86 / $128.82	Professional		$26.92	$75.86	$128.82
United Facility/Professional Facility Modifier Low / Median / High Price $1,348.96 / $2,884.03 / $7,762.47	Facility		$1,348.96	$2,884.03	$7,762.47
United Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $58.88 / $144.54	Professional		$28.18	$58.88	$144.54