Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $257.77 / $2,664.47 / $7,076.00	Facility		$257.77	$2,664.47	$7,076.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $82.75 / $97.71 / $1,053.92	Facility	52	$82.75	$97.71	$1,053.92
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $33.10 / $39.08 / $421.57	Facility	53	$33.10	$39.08	$421.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $149.91 / $228.29 / $1,471.23	Professional		$149.91	$228.29	$1,471.23
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $78.53 / $143.71 / $244.98	Professional		$78.53	$143.71	$244.98
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $2,104.85 / $4,993.27 / $8,800.00	Facility		$2,104.85	$4,993.27	$8,800.00
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 $158.69 / $389.12 / $2,175.84	Professional		$158.69	$389.12	$2,175.84
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $120.00 / $268.13 / $1,718.37	Professional		$120.00	$268.13	$1,718.37
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,844.73 / $4,611.96 / $8,185.41	Facility		$3,844.73	$4,611.96	$8,185.41
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $127.35 / $493.43 / $1,835.65	Professional		$127.35	$493.43	$1,835.65
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 $157.91 / $1,112.45 / $2,500.64	Professional		$157.91	$1,112.45	$2,500.64