Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $869.22 / $4,174.00 / $10,000.36	Facility		$869.22	$4,174.00	$10,000.36
Aetna Facility/Professional Facility Modifier 22 Low / Median / High Price $4,406.93 / $4,406.93 / $4,406.93	Facility	22	$4,406.93	$4,406.93	$4,406.93
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $6,976.00 / $7,896.00 / $11,637.03	Facility	50	$6,976.00	$7,896.00	$11,637.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $302.55 / $380.38 / $597.20	Professional		$302.55	$380.38	$597.20
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $2,565.00 / $2,565.00 / $2,565.00	Facility		$2,565.00	$2,565.00	$2,565.00
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 $326.14 / $548.72 / $1,126.17	Professional		$326.14	$548.72	$1,126.17
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $397.34 / $538.15 / $642.64	Professional		$397.34	$538.15	$642.64
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $7,587.62 / $9,533.65 / $18,183.06	Facility		$7,587.62	$9,533.65	$18,183.06
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $286.94 / $384.84 / $764.37	Professional		$286.94	$384.84	$764.37
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 $252.73 / $395.96 / $805.90	Professional		$252.73	$395.96	$805.90