Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $268.47 / $4,370.00 / $8,155.00	Facility		$268.47	$4,370.00	$8,155.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $127.65 / $134.24 / $607.33	Facility	52	$127.65	$134.24	$607.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $199.98 / $302.44 / $878.78	Professional		$199.98	$302.44	$878.78
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $187.45 / $194.65 / $195.44	Professional		$187.45	$194.65	$195.44
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $223.98 / $223.98 / $223.98	Professional		$223.98	$223.98	$223.98
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 $217.59 / $490.71 / $1,313.86	Professional		$217.59	$490.71	$1,313.86
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $207.19 / $363.04 / $1,047.93	Professional		$207.19	$363.04	$1,047.93
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,721.86 / $4,226.74 / $8,185.41	Facility		$3,721.86	$4,226.74	$8,185.41
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $166.72 / $568.29 / $984.01	Professional		$166.72	$568.29	$984.01
United Facility/Professional Facility Modifier Low / Median / High Price $1,941.00 / $4,700.00 / $7,579.00	Facility		$1,941.00	$4,700.00	$7,579.00
United Facility/Professional Professional Modifier Low / Median / High Price $216.03 / $663.55 / $1,527.83	Professional		$216.03	$663.55	$1,527.83