Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $545.09 / $4,895.00 / $8,223.35	Facility		$545.09	$4,895.00	$8,223.35
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $210.61 / $236.25 / $277.92	Facility	52	$210.61	$236.25	$277.92
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $84.24 / $94.50 / $111.17	Facility	53	$84.24	$94.50	$111.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $324.05 / $472.50 / $595.62	Professional		$324.05	$472.50	$595.62
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $299.77 / $299.77 / $337.22	Professional		$299.77	$299.77	$337.22
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $399.51 / $908.66 / $8,800.00	Facility		$399.51	$908.66	$8,800.00
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $477.32 / $477.32 / $477.32	Professional		$477.32	$477.32	$477.32
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 $263.56 / $477.47 / $792.19	Professional		$263.56	$477.47	$792.19
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $333.32 / $487.54 / $640.71	Professional		$333.32	$487.54	$640.71
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $6,033.17 / $6,667.30 / $11,833.25	Facility		$6,033.17	$6,667.30	$11,833.25
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $264.39 / $387.33 / $718.10	Professional		$264.39	$387.33	$718.10
United Facility/Professional Facility Modifier Low / Median / High Price $3,204.00 / $5,225.00 / $10,536.00	Facility		$3,204.00	$5,225.00	$10,536.00
United Facility/Professional Professional Modifier Low / Median / High Price $236.87 / $346.10 / $751.11	Professional		$236.87	$346.10	$751.11