Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $210.91 / $2,779.50 / $7,757.42	Facility		$210.91	$2,779.50	$7,757.42
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $89.85 / $105.46 / $373.15	Facility	52	$89.85	$105.46	$373.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $162.16 / $229.90 / $557.39	Professional		$162.16	$229.90	$557.39
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $140.50 / $157.44 / $245.84	Professional		$140.50	$157.44	$245.84
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $176.05 / $176.05 / $176.05	Professional		$176.05	$176.05	$176.05
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 $171.91 / $363.29 / $825.04	Professional		$171.91	$363.29	$825.04
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $90.00 / $268.13 / $677.62	Professional		$90.00	$268.13	$677.62
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,900.21 / $2,195.32 / $4,347.04	Facility		$1,900.21	$2,195.32	$4,347.04
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $151.43 / $361.03 / $647.69	Professional		$151.43	$361.03	$647.69
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 $141.03 / $385.00 / $853.37	Professional		$141.03	$385.00	$853.37