Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $139.43 / $4,294.00 / $9,950.00	Facility		$139.43	$4,294.00	$9,950.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $3,023.00 / $3,023.00 / $3,023.00	Facility	50	$3,023.00	$3,023.00	$3,023.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $110.35 / $141.38 / $209.78	Professional		$110.35	$141.38	$209.78
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $174.69 / $247.22 / $946.96	Professional	50	$174.69	$247.22	$946.96
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $146.37 / $146.37 / $215.94	Professional		$146.37	$146.37	$215.94
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $125.78 / $183.57 / $513.30	Professional		$125.78	$183.57	$513.30
AmeriHealth Facility/Professional Professional Modifier 50 Low / Median / High Price $251.55 / $251.55 / $353.75	Professional	50	$251.55	$251.55	$353.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.53 / $172.21 / $390.16	Professional		$97.53	$172.21	$390.16
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $131.07 / $170.07 / $400.07	Professional		$131.07	$170.07	$400.07
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $605.86 / $826.31 / $1,575.98	Facility		$605.86	$826.31	$1,575.98
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $97.12 / $157.51 / $224.37	Professional		$97.12	$157.51	$224.37
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 $114.36 / $157.51 / $289.95	Professional		$114.36	$157.51	$289.95