Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $977.24 / $4,365.16 / $6,309.57	Facility		$977.24	$4,365.16	$6,309.57
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,548.82 / $4,466.84 / $6,918.31	Facility	50	$1,548.82	$4,466.84	$6,918.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $269.15 / $1,071.52	Professional		$107.15	$269.15	$1,071.52
Aetna Facility/Professional Professional Modifier 22 Low / Median / High Price $141.25 / $141.25 / $190.55	Professional	22	$141.25	$141.25	$190.55
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $154.88 / $398.11 / $1,348.96	Professional	50	$154.88	$398.11	$1,348.96
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $36.31 / $36.31 / $37.15	Professional	53	$36.31	$36.31	$37.15
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $199.53 / $269.15	Professional		$109.65	$199.53	$269.15
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $147.91 / $204.17 / $407.38	Professional	50	$147.91	$204.17	$407.38
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $2,454.71 / $2,454.71 / $2,454.71	Facility		$2,454.71	$2,454.71	$2,454.71
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $190.55 / $1,659.59	Professional		$120.23	$190.55	$1,659.59
AmeriHealth Facility/Professional Professional Modifier 50 Low / Median / High Price $660.69 / $660.69 / $1,230.27	Professional	50	$660.69	$660.69	$1,230.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $245.47 / $724.44	Professional		$114.82	$245.47	$724.44
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $346.74 / $1,621.81	Professional		$223.87	$346.74	$1,621.81
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,819.70 / $2,884.03 / $4,570.88	Facility		$1,819.70	$2,884.03	$4,570.88
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $245.47 / $741.31	Professional		$89.13	$245.47	$741.31
United Facility/Professional Facility Modifier Low / Median / High Price $1,862.09 / $3,715.35 / $7,762.47	Facility		$1,862.09	$3,715.35	$7,762.47
United Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $208.93 / $501.19	Professional		$85.11	$208.93	$501.19