Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $288.02 / $2,306.21 / $6,458.54	Facility		$288.02	$2,306.21	$6,458.54
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $68.79 / $162.51 / $1,306.00	Facility	52	$68.79	$162.51	$1,306.00
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $27.52 / $41.22 / $105.29	Facility	53	$27.52	$41.22	$105.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $122.81 / $263.06 / $444.48	Professional		$122.81	$263.06	$444.48
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $66.81 / $115.19 / $280.55	Professional		$66.81	$115.19	$280.55
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $2,882.35 / $2,882.35 / $2,882.35	Facility		$2,882.35	$2,882.35	$2,882.35
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $65.44 / $197.20 / $1,593.72	Professional		$65.44	$197.20	$1,593.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,438.00 / $3,438.00 / $3,438.00	Facility		$3,438.00	$3,438.00	$3,438.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $133.80 / $292.88 / $643.82	Professional		$133.80	$292.88	$643.82
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $121.88 / $341.25 / $492.86	Professional		$121.88	$341.25	$492.86
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,839.48 / $1,839.48 / $4,347.04	Facility		$1,839.48	$1,839.48	$4,347.04
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $112.22 / $280.08 / $487.69	Professional		$112.22	$280.08	$487.69
United Facility/Professional Facility Modifier Low / Median / High Price $3,204.00 / $5,225.00 / $10,536.00	Facility		$3,204.00	$5,225.00	$10,536.00
United Facility/Professional Professional Modifier Low / Median / High Price $197.36 / $310.70 / $647.40	Professional		$197.36	$310.70	$647.40