Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $794.33 / $3,311.31 / $6,918.31	Facility		$794.33	$3,311.31	$6,918.31
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $446.68 / $1,348.96 / $3,019.95	Facility	52	$446.68	$1,348.96	$3,019.95
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $63.10 / $154.88 / $5,495.41	Facility	53	$63.10	$154.88	$5,495.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $363.08 / $1,288.25	Professional		$181.97	$363.08	$1,288.25
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $79.43 / $154.88 / $331.13	Professional	53	$79.43	$154.88	$331.13
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $181.97 / $346.74	Professional		$158.49	$181.97	$346.74
Ambetter Facility/Professional Professional Modifier 53 Low / Median / High Price $57.54 / $89.13 / $158.49	Professional	53	$57.54	$89.13	$158.49
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $1,071.52 / $2,398.83 / $3,715.35	Facility		$1,071.52	$2,398.83	$3,715.35
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $549.54 / $1,698.24	Professional		$194.98	$549.54	$1,698.24
AmeriHealth Facility/Professional Professional Modifier 53 Low / Median / High Price $117.49 / $117.49 / $239.88	Professional	53	$117.49	$117.49	$239.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $309.03 / $2,754.23 / $3,630.78	Facility		$309.03	$2,754.23	$3,630.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $380.19 / $758.58	Professional		$199.53	$380.19	$758.58
Cigna Facility/Professional Professional Modifier 53 Low / Median / High Price $67.61 / $177.83 / $338.84	Professional	53	$67.61	$177.83	$338.84
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $398.11 / $724.44	Professional		$123.03	$398.11	$724.44
Emblem Health Facility/Professional Professional Modifier 53 Low / Median / High Price $199.53 / $263.03 / $389.05	Professional	53	$199.53	$263.03	$389.05
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,905.46 / $2,951.21 / $4,677.35	Facility		$1,905.46	$2,951.21	$4,677.35
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $354.81 / $776.25	Professional		$147.91	$354.81	$776.25
United Facility/Professional Facility Modifier Low / Median / High Price $2,089.30 / $5,011.87 / $8,511.38	Facility		$2,089.30	$5,011.87	$8,511.38
United Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $295.12 / $602.56	Professional		$151.36	$295.12	$602.56