Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $25.70 / $56.23 / $158.49	Facility		$25.70	$56.23	$158.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.78 / $21.88 / $30.20	Professional		$17.78	$21.88	$30.20
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $12.88 / $15.85 / $21.88	Professional		$12.88	$15.85	$21.88
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $25.70 / $407.38 / $5,011.87	Facility		$25.70	$407.38	$5,011.87
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $42.66 / $45.71	Professional		$19.05	$42.66	$45.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $25.12 / $56.23 / $117.49	Facility		$25.12	$56.23	$117.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $16.60 / $25.70 / $38.90	Professional		$16.60	$25.70	$38.90
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $10.23 / $12.88 / $28.84	Professional		$10.23	$12.88	$28.84
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $25.70 / $10,471.29 / $25,118.86	Facility		$25.70	$10,471.29	$25,118.86
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $23.44 / $28.18	Professional		$22.39	$23.44	$28.18
United Facility/Professional Facility Modifier Low / Median / High Price $12.02 / $25.70 / $52.48	Facility		$12.02	$25.70	$52.48
United Facility/Professional Professional Modifier Low / Median / High Price $9.77 / $15.14 / $37.15	Professional		$9.77	$15.14	$37.15