Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $199.53 / $691.83	Facility		$177.83	$199.53	$691.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $104.71 / $199.53	Professional		$77.62	$104.71	$199.53
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $85.11 / $85.11	Professional		$85.11	$85.11	$85.11
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $138.04 / $138.04	Professional		$138.04	$138.04	$138.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $316.23 / $660.69	Facility		$162.18	$316.23	$660.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $147.91 / $263.03	Professional		$83.18	$147.91	$263.03
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $151.36 / $269.15	Professional		$85.11	$151.36	$269.15
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $10,471.29 / $25,703.96	Facility		$134.90	$10,471.29	$25,703.96
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $112.20 / $141.25	Professional		$112.20	$112.20	$141.25
United Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $141.25 / $295.12	Facility		$67.61	$141.25	$295.12
United Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $85.11 / $158.49	Professional		$57.54	$85.11	$158.49