Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $346.74 / $3,548.13 / $7,413.10	Facility		$346.74	$3,548.13	$7,413.10
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $3,019.95 / $3,019.95 / $3,019.95	Facility	53	$3,019.95	$3,019.95	$3,019.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $245.47 / $933.25	Professional		$83.18	$245.47	$933.25
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $45.71 / $158.49 / $239.88	Professional	52	$45.71	$158.49	$239.88
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $26.30 / $34.67 / $34.67	Professional	53	$26.30	$34.67	$34.67
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $100.00 / $263.03	Professional		$79.43	$100.00	$263.03
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $1,096.48 / $1,096.48 / $1,096.48	Facility		$1,096.48	$1,096.48	$1,096.48
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $234.42 / $234.42	Professional		$234.42	$234.42	$234.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $251.19 / $549.54	Professional		$102.33	$251.19	$549.54
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $223.87 / $354.81	Professional		$25.70	$223.87	$354.81
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,412.54 / $2,137.96 / $3,388.44	Facility		$1,412.54	$2,137.96	$3,388.44
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $208.93 / $457.09	Professional		$66.07	$208.93	$457.09
United Facility/Professional Facility Modifier Low / Median / High Price $1,862.09 / $3,630.78 / $7,762.47	Facility		$1,862.09	$3,630.78	$7,762.47
United Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $165.96 / $380.19	Professional		$64.57	$165.96	$380.19