Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $20.72 / $62.74 / $160.71	Facility		$20.72	$62.74	$160.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.72 / $23.92 / $24.28	Professional		$20.72	$23.92	$24.28
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $16.07 / $17.85 / $18.59	Professional		$16.07	$17.85	$18.59
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $72.03 / $72.03 / $72.03	Facility		$72.03	$72.03	$72.03
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $36.22 / $36.22 / $63.80	Professional		$36.22	$36.22	$63.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $18.71 / $59.18 / $122.72	Facility		$18.71	$59.18	$122.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $17.16 / $21.84 / $38.72	Professional		$17.16	$21.84	$38.72
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $12.32 / $15.80 / $23.40	Professional		$12.32	$15.80	$23.40
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $18.75 / $13,785.00 / $13,785.00	Facility		$18.75	$13,785.00	$13,785.00
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $18.75 / $18.75 / $24.61	Professional		$18.75	$18.75	$24.61
United Facility/Professional Professional Modifier Low / Median / High Price $10.71 / $16.07 / $37.40	Professional		$10.71	$16.07	$37.40