Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,482.47 / $7,034.40 / $12,867.62	Facility		$1,482.47	$7,034.40	$12,867.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,179.17 / $1,482.47 / $1,913.14	Professional		$1,179.17	$1,482.47	$1,913.14
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,187.60 / $1,267.72 / $2,190.48	Professional		$1,187.60	$1,267.72	$2,190.48
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $27,702.00 / $27,702.00 / $27,702.00	Facility		$27,702.00	$27,702.00	$27,702.00
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $1,282.84 / $1,815.65 / $10,827.75	Professional		$1,282.84	$1,815.65	$10,827.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $955.18 / $1,796.60 / $4,221.45	Professional		$955.18	$1,796.60	$4,221.45
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $884.50 / $1,387.87 / $1,838.19	Professional		$884.50	$1,387.87	$1,838.19
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $8,153.34 / $9,780.39 / $19,863.39	Facility		$8,153.34	$9,780.39	$19,863.39
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $978.27 / $1,254.48 / $2,339.31	Professional		$978.27	$1,254.48	$2,339.31
United Facility/Professional Facility Modifier Low / Median / High Price $5,667.00 / $9,969.00 / $19,696.00	Facility		$5,667.00	$9,969.00	$19,696.00
United Facility/Professional Professional Modifier Low / Median / High Price $970.47 / $1,352.21 / $2,640.83	Professional		$970.47	$1,352.21	$2,640.83