Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,129.27 / $6,045.33 / $11,759.80	Facility		$3,129.27	$6,045.33	$11,759.80
Aetna Facility/Professional Facility Modifier 22 Low / Median / High Price $8,504.00 / $8,504.00 / $8,504.00	Facility	22	$8,504.00	$8,504.00	$8,504.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $324.61 / $324.61 / $561.02	Facility	52	$324.61	$324.61	$561.02
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $129.84 / $129.84 / $224.41	Facility	53	$129.84	$129.84	$224.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $630.87 / $707.08 / $1,210.46	Professional		$630.87	$707.08	$1,210.46
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $696.39 / $1,139.26 / $1,220.82	Professional		$696.39	$1,139.26	$1,220.82
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $8,075.00 / $8,075.00 / $8,075.00	Facility		$8,075.00	$8,075.00	$8,075.00
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $585.78 / $900.69 / $2,544.90	Professional		$585.78	$900.69	$2,544.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $561.57 / $905.76 / $1,832.31	Professional		$561.57	$905.76	$1,832.31
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $713.86 / $1,031.27 / $2,776.13	Professional		$713.86	$1,031.27	$2,776.13
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $11,824.80 / $14,184.51 / $14,184.51	Facility		$11,824.80	$14,184.51	$14,184.51
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $540.15 / $769.68 / $1,429.96	Professional		$540.15	$769.68	$1,429.96
United Facility/Professional Facility Modifier Low / Median / High Price $5,682.00 / $10,536.00 / $23,258.00	Facility		$5,682.00	$10,536.00	$23,258.00
United Facility/Professional Professional Modifier Low / Median / High Price $480.50 / $727.19 / $1,549.77	Professional		$480.50	$727.19	$1,549.77