Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $377.77 / $3,870.00 / $9,784.00	Facility		$377.77	$3,870.00	$9,784.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $220.88 / $283.33 / $313.61	Facility	54	$220.88	$283.33	$313.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $227.86 / $294.70 / $490.37	Professional		$227.86	$294.70	$490.37
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $170.90 / $218.18 / $313.61	Professional	54	$170.90	$218.18	$313.61
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $34.18 / $43.64 / $62.72	Professional	55	$34.18	$43.64	$62.72
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $322.47 / $322.47 / $393.30	Professional		$322.47	$322.47	$393.30
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $313.24 / $442.65 / $1,280.00	Professional		$313.24	$442.65	$1,280.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $196.32 / $376.23 / $865.10	Professional		$196.32	$376.23	$865.10
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $265.26 / $350.87 / $825.38	Professional		$265.26	$350.87	$825.38
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,076.33 / $1,333.77 / $2,708.77	Facility		$1,076.33	$1,333.77	$2,708.77
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $194.48 / $322.82 / $478.68	Professional		$194.48	$322.82	$478.68
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 $242.19 / $361.86 / $672.21	Professional		$242.19	$361.86	$672.21