Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $593.96 / $2,384.84 / $6,845.00	Facility		$593.96	$2,384.84	$6,845.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $145.65 / $254.78 / $2,277.91	Facility	52	$145.65	$254.78	$2,277.91
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $58.26 / $85.06 / $159.79	Facility	53	$58.26	$85.06	$159.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $260.81 / $466.21 / $980.16	Professional		$260.81	$466.21	$980.16
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $51.93 / $85.56 / $122.86	Professional	53	$51.93	$85.56	$122.86
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $242.25 / $266.20 / $465.85	Professional		$242.25	$266.20	$465.85
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $1,188.00 / $6,708.00 / $14,009.39	Facility		$1,188.00	$6,708.00	$14,009.39
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $269.67 / $367.99 / $1,092.82	Professional		$269.67	$367.99	$1,092.82
AmeriHealth Facility/Professional Professional Modifier 53 Low / Median / High Price $26.98 / $26.98 / $26.98	Professional	53	$26.98	$26.98	$26.98
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 $283.44 / $511.48 / $1,089.95	Professional		$283.44	$511.48	$1,089.95
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $210.00 / $560.63 / $773.07	Professional		$210.00	$560.63	$773.07
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 $232.42 / $438.35 / $840.59	Professional		$232.42	$438.35	$840.59
United Facility/Professional Facility Modifier Low / Median / High Price $1,533.00 / $4,700.00 / $8,540.00	Facility		$1,533.00	$4,700.00	$8,540.00
United Facility/Professional Professional Modifier Low / Median / High Price $339.29 / $479.89 / $1,069.03	Professional		$339.29	$479.89	$1,069.03