Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $23.99 / $74.13 / $194.98	Facility		$23.99	$74.13	$194.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $13.49 / $16.98 / $33.11	Professional		$13.49	$16.98	$33.11
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $15.14 / $15.14 / $15.14	Professional		$15.14	$15.14	$15.14
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $117.49 / $120.23	Facility		$117.49	$117.49	$120.23
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $18.20 / $33.11	Professional		$18.20	$18.20	$33.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $23.44 / $53.70 / $109.65	Facility		$23.44	$53.70	$109.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $12.02 / $18.20 / $35.48	Professional		$12.02	$18.20	$35.48
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $9.55 / $12.02 / $20.42	Professional		$9.55	$12.02	$20.42
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $23.99 / $10,471.29 / $25,118.86	Facility		$23.99	$10,471.29	$25,118.86
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $16.22 / $17.38 / $21.38	Professional		$16.22	$17.38	$21.38
United Facility/Professional Facility Modifier Low / Median / High Price $11.22 / $23.99 / $48.98	Facility		$11.22	$23.99	$48.98
United Facility/Professional Professional Modifier Low / Median / High Price $9.55 / $14.45 / $26.30	Professional		$9.55	$14.45	$26.30