Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $142.55 / $1,672.48 / $6,153.00	Facility		$142.55	$1,672.48	$6,153.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,993.50 / $2,086.88 / $3,051.50	Facility	50	$1,993.50	$2,086.88	$3,051.50
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $12.82 / $17.10 / $28.51	Facility	53	$12.82	$17.10	$28.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.43 / $91.09 / $149.41	Professional		$47.43	$91.09	$149.41
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $115.18 / $115.18 / $115.18	Professional		$115.18	$115.18	$115.18
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $1,224.43 / $1,224.43 / $1,224.43	Facility		$1,224.43	$1,224.43	$1,224.43
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $54.36 / $716.80 / $768.00	Professional		$54.36	$716.80	$768.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.40 / $117.68 / $307.95	Professional		$58.40	$117.68	$307.95
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $102.43 / $168.97 / $174.71	Professional		$102.43	$168.97	$174.71
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.03 / $102.94 / $213.01	Professional		$43.03	$102.94	$213.01
United Facility/Professional Facility Modifier Low / Median / High Price $1,529.00 / $3,352.00 / $10,536.00	Facility		$1,529.00	$3,352.00	$10,536.00
United Facility/Professional Professional Modifier Low / Median / High Price $89.89 / $146.08 / $295.83	Professional		$89.89	$146.08	$295.83