Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $303.69 / $4,895.00 / $9,842.00	Facility		$303.69	$4,895.00	$9,842.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,528.56 / $1,528.56 / $1,528.56	Facility	50	$1,528.56	$1,528.56	$1,528.56
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $193.63 / $228.82 / $244.07	Facility	54	$193.63	$228.82	$244.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $208.87 / $286.69 / $390.84	Professional		$208.87	$286.69	$390.84
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $156.65 / $215.02 / $293.13	Professional	54	$156.65	$215.02	$293.13
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $30.64 / $41.82 / $50.11	Professional	55	$30.64	$41.82	$50.11
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $189.68 / $189.68 / $225.06	Professional		$189.68	$189.68	$225.06
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $221.33 / $337.29 / $640.15	Professional		$221.33	$337.29	$640.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $169.42 / $340.61 / $802.87	Professional		$169.42	$340.61	$802.87
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $281.02 / $293.80 / $677.72	Professional		$281.02	$293.80	$677.72
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,284.56 / $1,516.43 / $2,892.22	Facility		$1,284.56	$1,516.43	$2,892.22
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $169.35 / $281.44 / $470.97	Professional		$169.35	$281.44	$470.97
United Facility/Professional Facility Modifier Low / Median / High Price $2,284.00 / $3,961.00 / $10,536.00	Facility		$2,284.00	$3,961.00	$10,536.00
United Facility/Professional Professional Modifier Low / Median / High Price $202.16 / $308.50 / $593.09	Professional		$202.16	$308.50	$593.09