Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $46.23 / $123.00 / $449.50	Facility		$46.23	$123.00	$449.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $55.63 / $120.00 / $124.85	Professional		$55.63	$120.00	$124.85
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $50.00 / $60.00	Professional		$30.00	$50.00	$60.00
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $683.20 / $683.20 / $683.20	Facility		$683.20	$683.20	$683.20
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $5.05 / $75.00 / $147.50	Professional		$5.05	$75.00	$147.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $69.88 / $200.00 / $458.24	Facility		$69.88	$200.00	$458.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.80 / $54.49 / $114.81	Professional		$43.80	$54.49	$114.81
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $46.00 / $55.00 / $80.00	Professional		$46.00	$55.00	$80.00
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $70.00 / $8,702.00 / $13,785.00	Facility		$70.00	$8,702.00	$13,785.00
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $69.78 / $70.00 / $70.00	Professional		$69.78	$70.00	$70.00
United Facility/Professional Professional Modifier Low / Median / High Price $35.00 / $60.00 / $102.00	Professional		$35.00	$60.00	$102.00