Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $265.80 / $2,211.86 / $7,684.00	Facility		$265.80	$2,211.86	$7,684.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $116.13 / $220.78 / $399.53	Facility	52	$116.13	$220.78	$399.53
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $46.45 / $67.37 / $156.72	Facility	53	$46.45	$67.37	$156.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $207.34 / $404.66 / $625.80	Professional		$207.34	$404.66	$625.80
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $94.18 / $94.18 / $118.13	Professional		$94.18	$94.18	$118.13
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $1,658.27 / $2,762.55 / $4,066.33	Facility		$1,658.27	$2,762.55	$4,066.33
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $106.21 / $378.75 / $635.25	Professional		$106.21	$378.75	$635.25
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 $217.87 / $442.99 / $927.46	Professional		$217.87	$442.99	$927.46
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $452.33 / $659.84 / $869.48	Professional		$452.33	$659.84	$869.48
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,389.71 / $2,866.57 / $6,216.17	Facility		$2,389.71	$2,866.57	$6,216.17
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $183.21 / $420.65 / $730.75	Professional		$183.21	$420.65	$730.75
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 $318.52 / $458.60 / $1,020.56	Professional		$318.52	$458.60	$1,020.56