Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $364.55 / $3,659.45 / $6,325.00	Facility		$364.55	$3,659.45	$6,325.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $51.50 / $156.83 / $3,199.00	Facility	52	$51.50	$156.83	$3,199.00
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $20.60 / $62.73 / $107.24	Facility	53	$20.60	$62.73	$107.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.14 / $259.47 / $395.11	Professional		$97.14	$259.47	$395.11
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $99.77 / $99.77 / $99.77	Professional		$99.77	$99.77	$99.77
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $1,748.25 / $6,493.50 / $10,417.42	Facility		$1,748.25	$6,493.50	$10,417.42
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $92.41 / $230.81 / $1,235.05	Professional		$92.41	$230.81	$1,235.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $114.04 / $266.33 / $628.73	Professional		$114.04	$266.33	$628.73
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $295.67 / $400.79 / $531.60	Professional		$295.67	$400.79	$531.60
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,900.21 / $2,279.40 / $4,629.32	Facility		$1,900.21	$2,279.40	$4,629.32
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $275.48 / $517.25	Professional		$97.72	$275.48	$517.25
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 $208.11 / $311.62 / $679.92	Professional		$208.11	$311.62	$679.92