Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $750.61 / $6,986.00 / $12,831.00	Facility		$750.61	$6,986.00	$12,831.00
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $150.12 / $150.12 / $150.12	Facility	53	$150.12	$150.12	$150.12
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $562.96 / $562.96 / $562.96	Facility	54	$562.96	$562.96	$562.96
Aetna Facility/Professional Facility Modifier 55 Low / Median / High Price $112.59 / $112.59 / $112.59	Facility	55	$112.59	$112.59	$112.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $584.94 / $727.07 / $1,067.19	Professional		$584.94	$727.07	$1,067.19
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $87.79 / $104.00 / $138.09	Professional	55	$87.79	$104.00	$138.09
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $1,020.00 / $1,020.00 / $1,020.00	Professional		$1,020.00	$1,020.00	$1,020.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $537.34 / $899.38 / $2,018.93	Professional		$537.34	$899.38	$2,018.93
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $594.44 / $802.18 / $1,887.03	Professional		$594.44	$802.18	$1,887.03
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $12,081.58 / $22,263.86 / $27,202.13	Facility		$12,081.58	$22,263.86	$27,202.13
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $566.40 / $775.56 / $1,120.19	Professional		$566.40	$775.56	$1,120.19
United Facility/Professional Facility Modifier Low / Median / High Price $3,161.00 / $7,763.00 / $19,490.00	Facility		$3,161.00	$7,763.00	$19,490.00
United Facility/Professional Professional Modifier Low / Median / High Price $561.98 / $777.68 / $1,437.57	Professional		$561.98	$777.68	$1,437.57