Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $52.76 / $135.78 / $207.10	Facility		$52.76	$135.78	$207.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $86.32 / $135.78 / $228.80	Professional		$86.32	$135.78	$228.80
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $75.02 / $86.09 / $187.50	Professional		$75.02	$86.09	$187.50
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $89.61 / $120.30 / $244.92	Facility		$89.61	$120.30	$244.92
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $48.77 / $109.20 / $244.24	Professional		$48.77	$109.20	$244.24
Cigna Facility/Professional Facility Modifier Low / Median / High Price $141.02 / $215.57 / $411.77	Facility		$141.02	$215.57	$411.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.31 / $187.47 / $329.06	Professional		$97.31	$187.47	$329.06
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $179.75 / $202.78 / $280.02	Professional		$179.75	$202.78	$280.02
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $96.30 / $113.29 / $189.05	Professional		$96.30	$113.29	$189.05
United Facility/Professional Professional Modifier Low / Median / High Price $97.88 / $151.05 / $264.44	Professional		$97.88	$151.05	$264.44