Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $695.30 / $4,370.00 / $9,860.00	Facility		$695.30	$4,370.00	$9,860.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $521.48 / $521.48 / $765.00	Facility	54	$521.48	$521.48	$765.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $633.88 / $812.08 / $1,198.02	Professional		$633.88	$812.08	$1,198.02
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $95.08 / $121.81 / $179.70	Professional	55	$95.08	$121.81	$179.70
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $1,105.50 / $1,105.50 / $1,105.50	Professional		$1,105.50	$1,105.50	$1,105.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $634.79 / $946.39 / $2,174.42	Professional		$634.79	$946.39	$2,174.42
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $731.88 / $966.19 / $2,272.84	Professional		$731.88	$966.19	$2,272.84
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $8,153.34 / $9,780.39 / $21,208.63	Facility		$8,153.34	$9,780.39	$21,208.63
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $651.44 / $886.76 / $1,217.79	Professional		$651.44	$886.76	$1,217.79
United Facility/Professional Facility Modifier Low / Median / High Price $3,885.00 / $7,250.00 / $10,536.00	Facility		$3,885.00	$7,250.00	$10,536.00
United Facility/Professional Professional Modifier Low / Median / High Price $605.11 / $809.41 / $1,473.64	Professional		$605.11	$809.41	$1,473.64