Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $22.00 / $56.59 / $264.60	Facility		$22.00	$56.59	$264.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $18.07 / $22.09 / $25.81	Professional		$18.07	$22.09	$25.81
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $7.74 / $12.91 / $17.93	Professional		$7.74	$12.91	$17.93
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $65.12 / $272.83 / $2,501.13	Facility		$65.12	$272.83	$2,501.13
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $19.36 / $42.66 / $54.00	Professional		$19.36	$42.66	$54.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $18.04 / $57.02 / $118.27	Facility		$18.04	$57.02	$118.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $16.86 / $26.13 / $46.79	Professional		$16.86	$26.13	$46.79
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $11.87 / $15.23 / $25.81	Professional		$11.87	$15.23	$25.81
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $18.07 / $13,785.00 / $13,785.00	Facility		$18.07	$13,785.00	$13,785.00
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $18.07 / $18.07 / $23.72	Professional		$18.07	$18.07	$23.72
United Facility/Professional Facility Modifier Low / Median / High Price $14.20 / $14.20 / $14.20	Facility		$14.20	$14.20	$14.20
United Facility/Professional Professional Modifier Low / Median / High Price $10.84 / $15.49 / $36.08	Professional		$10.84	$15.49	$36.08