Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $622.42 / $4,294.00 / $9,860.00	Facility		$622.42	$4,294.00	$9,860.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $410.51 / $466.82 / $638.60	Facility	54	$410.51	$466.82	$638.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $523.44 / $652.91 / $965.43	Professional		$523.44	$652.91	$965.43
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $392.58 / $484.86 / $724.07	Professional	54	$392.58	$484.86	$724.07
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $78.52 / $96.97 / $144.81	Professional	55	$78.52	$96.97	$144.81
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $656.26 / $656.26 / $656.26	Professional		$656.26	$656.26	$656.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $489.58 / $785.68 / $1,946.36	Professional		$489.58	$785.68	$1,946.36
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $610.91 / $820.50 / $1,930.13	Professional		$610.91	$820.50	$1,930.13
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,900.26 / $4,179.20 / $4,782.30	Facility		$1,900.26	$4,179.20	$4,782.30
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $496.54 / $736.06 / $1,006.59	Professional		$496.54	$736.06	$1,006.59
United Facility/Professional Facility Modifier Low / Median / High Price $3,425.00 / $5,265.00 / $10,536.00	Facility		$3,425.00	$5,265.00	$10,536.00
United Facility/Professional Professional Modifier Low / Median / High Price $489.83 / $702.88 / $1,340.13	Professional		$489.83	$702.88	$1,340.13