Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $588.03 / $3,804.58 / $7,918.00	Facility		$588.03	$3,804.58	$7,918.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $923.09 / $4,162.88 / $8,338.50	Facility	50	$923.09	$4,162.88	$8,338.50
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $91.39 / $129.29 / $313.63	Facility	52	$91.39	$129.29	$313.63
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $36.54 / $51.72 / $125.45	Facility	53	$36.54	$51.72	$125.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $152.57 / $383.33 / $632.28	Professional		$152.57	$383.33	$632.28
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $246.70 / $246.70 / $246.70	Professional	50	$246.70	$246.70	$246.70
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $4,234.39 / $4,491.18 / $24,686.55	Facility		$4,234.39	$4,491.18	$24,686.55
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $81.44 / $81.44 / $162.19	Professional		$81.44	$81.44	$162.19
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 $159.40 / $414.00 / $1,251.85	Professional		$159.40	$414.00	$1,251.85
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $284.14 / $565.83 / $695.47	Professional		$284.14	$565.83	$695.47
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,080.00 / $6,766.81 / $8,385.14	Facility		$1,080.00	$6,766.81	$8,385.14
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $125.72 / $417.12 / $783.21	Professional		$125.72	$417.12	$783.21
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 $301.62 / $516.55 / $1,103.60	Professional		$301.62	$516.55	$1,103.60