Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,878.88 / $5,233.06 / $7,889.00	Facility		$2,878.88	$5,233.06	$7,889.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $132.80 / $162.44 / $1,282.52	Facility	52	$132.80	$162.44	$1,282.52
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $53.12 / $64.98 / $350.34	Facility	53	$53.12	$64.98	$350.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $237.39 / $372.88 / $1,537.57	Professional		$237.39	$372.88	$1,537.57
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $44.52 / $64.98 / $254.51	Professional	53	$44.52	$64.98	$254.51
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $2,762.50 / $8,013.00 / $16,055.00	Facility		$2,762.50	$8,013.00	$16,055.00
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $202.54 / $355.09 / $1,395.36	Professional		$202.54	$355.09	$1,395.36
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 $257.49 / $553.86 / $2,510.21	Professional		$257.49	$553.86	$2,510.21
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $426.88 / $1,897.01 / $2,328.87	Professional		$426.88	$1,897.01	$2,328.87
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $6,238.19 / $6,994.86 / $15,699.33	Facility		$6,238.19	$6,994.86	$15,699.33
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $189.35 / $720.23 / $2,050.48	Professional		$189.35	$720.23	$2,050.48
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 $484.19 / $1,554.95 / $3,175.68	Professional		$484.19	$1,554.95	$3,175.68