Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $174.75 / $1,713.52 / $6,396.00	Facility		$174.75	$1,713.52	$6,396.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $50.80 / $87.38 / $204.05	Facility	52	$50.80	$87.38	$204.05
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $20.32 / $34.95 / $81.62	Facility	53	$20.32	$34.95	$81.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.85 / $201.59 / $306.93	Professional		$93.85	$201.59	$306.93
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $46.93 / $87.38 / $135.75	Professional	52	$46.93	$87.38	$135.75
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $18.42 / $34.95 / $54.30	Professional	53	$18.42	$34.95	$54.30
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $84.45 / $84.45 / $84.45	Professional		$84.45	$84.45	$84.45
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $1,100.00 / $1,100.00 / $1,100.00	Facility		$1,100.00	$1,100.00	$1,100.00
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $234.91 / $325.33 / $688.26	Professional		$234.91	$325.33	$688.26
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 $101.62 / $263.25 / $575.39	Professional		$101.62	$263.25	$575.39
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $25.50 / $224.16 / $367.56	Professional		$25.50	$224.16	$367.56
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,468.41 / $1,562.90 / $1,845.02	Facility		$1,468.41	$1,562.90	$1,845.02
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $65.38 / $205.44 / $360.69	Professional		$65.38	$205.44	$360.69
United Facility/Professional Facility Modifier Low / Median / High Price $1,800.00 / $3,345.00 / $5,864.00	Facility		$1,800.00	$3,345.00	$5,864.00
United Facility/Professional Professional Modifier Low / Median / High Price $162.66 / $220.07 / $497.44	Professional		$162.66	$220.07	$497.44