Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $422.67 / $1,047.86 / $5,671.00	Facility		$422.67	$1,047.86	$5,671.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $81.27 / $166.43 / $346.53	Facility	52	$81.27	$166.43	$346.53
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $32.51 / $46.41 / $135.93	Facility	53	$32.51	$46.41	$135.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $138.69 / $315.47 / $597.72	Professional		$138.69	$315.47	$597.72
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $72.88 / $195.24 / $385.41	Professional		$72.88	$195.24	$385.41
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $860.52 / $2,040.50 / $7,142.12	Facility		$860.52	$2,040.50	$7,142.12
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $123.53 / $200.10 / $700.44	Professional		$123.53	$200.10	$700.44
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 $157.81 / $347.99 / $803.50	Professional		$157.81	$347.99	$803.50
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $150.00 / $354.66 / $637.14	Professional		$150.00	$354.66	$637.14
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,900.21 / $2,279.40 / $4,347.04	Facility		$1,900.21	$2,279.40	$4,347.04
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $126.46 / $355.90 / $650.26	Professional		$126.46	$355.90	$650.26
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 $252.22 / $383.63 / $838.56	Professional		$252.22	$383.63	$838.56