Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $175.00 / $217.36 / $921.00	Facility		$175.00	$217.36	$921.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $122.80 / $175.00 / $175.00	Professional		$122.80	$175.00	$175.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $92.10 / $92.10 / $92.10	Professional		$92.10	$92.10	$92.10
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $115.13 / $115.13 / $349.27	Professional		$115.13	$115.13	$349.27
Cigna Facility/Professional Facility Modifier Low / Median / High Price $150.05 / $338.50 / $703.39	Facility		$150.05	$338.50	$703.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.36 / $144.77 / $220.96	Professional		$81.36	$144.77	$220.96
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $43.30 / $76.75 / $92.10	Professional		$43.30	$76.75	$92.10
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $8,702.00 / $13,785.00 / $13,785.00	Facility		$8,702.00	$13,785.00	$13,785.00
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $99.78 / $99.78 / $102.85	Professional		$99.78	$99.78	$102.85
United Facility/Professional Professional Modifier Low / Median / High Price $59.43 / $92.10 / $157.34	Professional		$59.43	$92.10	$157.34