Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $157.91 / $4,134.00 / $9,842.00	Facility		$157.91	$4,134.00	$9,842.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $825.15 / $1,117.52 / $4,110.08	Facility	50	$825.15	$1,117.52	$4,110.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $90.55 / $118.82 / $200.88	Professional		$90.55	$118.82	$200.88
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $33.86 / $177.03 / $209.63	Professional	50	$33.86	$177.03	$209.63
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $122.18 / $122.18 / $171.10	Professional		$122.18	$122.18	$171.10
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $256.64 / $256.64 / $256.64	Professional	50	$256.64	$256.64	$256.64
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $106.55 / $156.19 / $411.01	Professional		$106.55	$156.19	$411.01
AmeriHealth Facility/Professional Professional Modifier 50 Low / Median / High Price $93.32 / $186.63 / $616.52	Professional	50	$93.32	$186.63	$616.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.37 / $151.38 / $338.21	Professional		$75.37	$151.38	$338.21
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $130.24 / $136.16 / $314.38	Professional		$130.24	$136.16	$314.38
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $729.71 / $806.41 / $1,748.69	Facility		$729.71	$806.41	$1,748.69
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $80.44 / $114.34 / $192.18	Professional		$80.44	$114.34	$192.18
United Facility/Professional Facility Modifier Low / Median / High Price $1,529.00 / $3,352.00 / $10,536.00	Facility		$1,529.00	$3,352.00	$10,536.00
United Facility/Professional Professional Modifier Low / Median / High Price $87.83 / $129.31 / $388.94	Professional		$87.83	$129.31	$388.94