Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $3,890.45 / $8,511.38	Facility		$891.25	$3,890.45	$8,511.38
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,230.27 / $5,248.07 / $8,511.38	Facility	50	$1,230.27	$5,248.07	$8,511.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $213.80 / $794.33	Professional		$102.33	$213.80	$794.33
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $162.18 / $338.84 / $1,380.38	Professional	50	$162.18	$338.84	$1,380.38
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $173.78 / $194.98	Professional		$125.89	$173.78	$194.98
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $186.21 / $251.19 / $281.84	Professional	50	$186.21	$251.19	$281.84
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $1,348.96 / $1,348.96 / $1,348.96	Professional		$1,348.96	$1,348.96	$1,348.96
AmeriHealth Facility/Professional Professional Modifier 50 Low / Median / High Price $489.78 / $489.78 / $489.78	Professional	50	$489.78	$489.78	$489.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $234.42 / $575.44	Professional		$114.82	$234.42	$575.44
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $269.15 / $1,905.46	Professional		$173.78	$269.15	$1,905.46
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 $85.11 / $204.17 / $660.69	Professional		$85.11	$204.17	$660.69
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 / $186.21 / $407.38	Professional		$85.11	$186.21	$407.38