Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $63.46 / $123.77 / $492.41	Facility		$63.46	$123.77	$492.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.18 / $85.26 / $111.96	Professional		$63.18	$85.26	$111.96
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $53.56 / $260.39 / $4,251.32	Facility		$53.56	$260.39	$4,251.32
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $44.79 / $52.69 / $190.08	Professional		$44.79	$52.69	$190.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $93.64 / $211.47 / $438.99	Facility		$93.64	$211.47	$438.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $84.72 / $124.72 / $237.60	Professional		$84.72	$124.72	$237.60
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $67.06 / $100.59 / $138.91	Professional		$67.06	$100.59	$138.91
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $67.06 / $13,785.00 / $13,785.00	Facility		$67.06	$13,785.00	$13,785.00
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $67.06 / $67.06 / $67.06	Professional		$67.06	$67.06	$67.06
United Facility/Professional Facility Modifier Low / Median / High Price $52.69 / $52.69 / $52.69	Facility		$52.69	$52.69	$52.69
United Facility/Professional Professional Modifier Low / Median / High Price $40.24 / $57.48 / $122.74	Professional		$40.24	$57.48	$122.74