Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $966.18 / $4,075.03 / $5,663.48	Facility		$966.18	$4,075.03	$5,663.48
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,565.27 / $4,436.16 / $5,563.06	Facility	50	$1,565.27	$4,436.16	$5,563.06
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $21.97 / $36.90 / $57.11	Facility	53	$21.97	$36.90	$57.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.54 / $219.71 / $373.22	Professional		$95.54	$219.71	$373.22
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $150.56 / $862.52 / $885.64	Professional	50	$150.56	$862.52	$885.64
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $19.11 / $41.42 / $57.42	Professional	53	$19.11	$41.42	$57.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $257.02 / $257.02 / $257.02	Professional		$257.02	$257.02	$257.02
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $178.32 / $178.32 / $178.32	Professional	50	$178.32	$178.32	$178.32
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $2,448.85 / $2,448.85 / $2,448.85	Facility		$2,448.85	$2,448.85	$2,448.85
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $98.43 / $251.04 / $878.75	Professional		$98.43	$251.04	$878.75
AmeriHealth Facility/Professional Professional Modifier 50 Low / Median / High Price $663.00 / $663.00 / $1,233.00	Professional	50	$663.00	$663.00	$1,233.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $121.85 / $254.36 / $729.66	Professional		$121.85	$254.36	$729.66
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $284.14 / $390.60 / $1,569.11	Professional		$284.14	$390.60	$1,569.11
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,804.40 / $1,983.68 / $4,395.92	Facility		$1,804.40	$1,983.68	$4,395.92
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $92.82 / $235.89 / $519.71	Professional		$92.82	$235.89	$519.71
United Facility/Professional Facility Modifier Low / Median / High Price $2,354.00 / $3,961.00 / $10,536.00	Facility		$2,354.00	$3,961.00	$10,536.00
United Facility/Professional Professional Modifier Low / Median / High Price $203.45 / $333.45 / $799.65	Professional		$203.45	$333.45	$799.65