Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $300.25 / $4,049.00 / $9,284.00	Facility		$300.25	$4,049.00	$9,284.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $211.52 / $225.19 / $310.55	Facility	54	$211.52	$225.19	$310.55
Aetna Facility/Professional Facility Modifier 55 Low / Median / High Price $42.30 / $45.04 / $62.11	Facility	55	$42.30	$45.04	$62.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $260.42 / $329.48 / $521.60	Professional		$260.42	$329.48	$521.60
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $562.74 / $562.74 / $562.74	Professional	50	$562.74	$562.74	$562.74
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $195.32 / $238.87 / $374.51	Professional	54	$195.32	$238.87	$374.51
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $39.06 / $47.77 / $74.90	Professional	55	$39.06	$47.77	$74.90
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $343.48 / $422.66 / $1,120.00	Professional		$343.48	$422.66	$1,120.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $250.97 / $383.54 / $965.45	Professional		$250.97	$383.54	$965.45
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $144.00 / $294.63 / $524.67	Professional		$144.00	$294.63	$524.67
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,206.90 / $1,333.77 / $2,708.77	Facility		$1,206.90	$1,333.77	$2,708.77
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $258.80 / $363.25 / $499.71	Professional		$258.80	$363.25	$499.71
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 $235.45 / $343.43 / $651.04	Professional		$235.45	$343.43	$651.04