Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $118.83 / $2,232.00 / $6,711.55	Facility		$118.83	$2,232.00	$6,711.55
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $35.50 / $82.66 / $261.83	Facility	52	$35.50	$82.66	$261.83
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $14.20 / $24.24 / $104.74	Facility	53	$14.20	$24.24	$104.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.11 / $152.38 / $335.73	Professional		$70.11	$152.38	$335.73
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $63.14 / $68.90 / $132.11	Professional		$63.14	$68.90	$132.11
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $2,184.30 / $2,184.30 / $2,184.30	Facility		$2,184.30	$2,184.30	$2,184.30
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $38.31 / $702.00 / $862.40	Professional		$38.31	$702.00	$862.40
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 $77.26 / $209.96 / $540.00	Professional		$77.26	$209.96	$540.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $49.50 / $146.25 / $470.97	Professional		$49.50	$146.25	$470.97
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,031.42 / $2,216.56 / $4,501.68	Facility		$2,031.42	$2,216.56	$4,501.68
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $65.65 / $235.74 / $419.70	Professional		$65.65	$235.74	$419.70
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 $135.78 / $279.80 / $664.06	Professional		$135.78	$279.80	$664.06