Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $94.16 / $2,135.00 / $6,481.00	Facility		$94.16	$2,135.00	$6,481.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $29.21 / $64.88 / $169.89	Facility	52	$29.21	$64.88	$169.89
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $11.68 / $25.95 / $66.64	Facility	53	$11.68	$25.95	$66.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $55.31 / $122.21 / $238.47	Professional		$55.31	$122.21	$238.47
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $21.64 / $53.04 / $149.46	Professional		$21.64	$53.04	$149.46
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $423.50 / $423.50 / $423.50	Professional		$423.50	$423.50	$423.50
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 $60.03 / $157.40 / $400.00	Professional		$60.03	$157.40	$400.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $37.50 / $136.50 / $311.86	Professional		$37.50	$136.50	$311.86
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,847.80 / $2,216.56 / $4,806.54	Facility		$1,847.80	$2,216.56	$4,806.54
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $51.43 / $161.19 / $276.23	Professional		$51.43	$161.19	$276.23
United Facility/Professional Facility Modifier Low / Median / High Price $1,882.00 / $3,823.00 / $10,536.00	Facility		$1,882.00	$3,823.00	$10,536.00
United Facility/Professional Professional Modifier Low / Median / High Price $103.95 / $179.67 / $394.64	Professional		$103.95	$179.67	$394.64