Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,273.00 / $5,982.00 / $11,298.00	Facility		$1,273.00	$5,982.00	$11,298.00
Aetna Facility/Professional Facility Modifier 22 Low / Median / High Price $4,342.00 / $4,342.00 / $4,342.00	Facility	22	$4,342.00	$4,342.00	$4,342.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $332.41 / $332.41 / $610.62	Facility	52	$332.41	$332.41	$610.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $664.82 / $897.88 / $1,350.58	Professional		$664.82	$897.88	$1,350.58
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $669.09 / $669.09 / $669.09	Professional		$669.09	$669.09	$669.09
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $4,553.34 / $4,553.34 / $11,055.20	Facility		$4,553.34	$4,553.34	$11,055.20
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 $681.87 / $1,167.38 / $2,501.01	Professional		$681.87	$1,167.38	$2,501.01
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $827.61 / $1,124.53 / $1,338.56	Professional		$827.61	$1,124.53	$1,338.56
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $11,326.97 / $21,935.56 / $25,101.06	Facility		$11,326.97	$21,935.56	$25,101.06
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $593.97 / $768.67 / $1,708.34	Professional		$593.97	$768.67	$1,708.34
United Facility/Professional Facility Modifier Low / Median / High Price $5,682.00 / $9,969.00 / $19,696.00	Facility		$5,682.00	$9,969.00	$19,696.00
United Facility/Professional Professional Modifier Low / Median / High Price $527.03 / $805.45 / $1,725.98	Professional		$527.03	$805.45	$1,725.98