Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $259.07 / $4,540.00 / $8,504.00	Facility		$259.07	$4,540.00	$8,504.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $9,379.95 / $9,807.00 / $9,879.86	Facility	50	$9,379.95	$9,807.00	$9,879.86
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $86.81 / $169.43 / $559.64	Facility	52	$86.81	$169.43	$559.64
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $34.72 / $67.77 / $223.86	Facility	53	$34.72	$67.77	$223.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $200.04 / $695.90 / $1,066.76	Professional		$200.04	$695.90	$1,066.76
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $4,165.00 / $4,165.00 / $4,165.00	Facility		$4,165.00	$4,165.00	$4,165.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $244.58 / $689.48 / $2,207.13	Professional		$244.58	$689.48	$2,207.13
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $366.36 / $1,319.33 / $1,623.51	Professional		$366.36	$1,319.33	$1,623.51
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,564.34 / $4,980.33 / $9,498.02	Facility		$4,564.34	$4,980.33	$9,498.02
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $167.61 / $820.87 / $1,408.37	Professional		$167.61	$820.87	$1,408.37
United Facility/Professional Facility Modifier Low / Median / High Price $4,415.00 / $7,250.00 / $10,536.00	Facility		$4,415.00	$7,250.00	$10,536.00
United Facility/Professional Professional Modifier Low / Median / High Price $647.37 / $914.90 / $2,134.07	Professional		$647.37	$914.90	$2,134.07