Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $263.03 / $389.05 / $1,513.56	Facility		$263.03	$389.05	$1,513.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $208.93 / $389.05	Professional		$169.82	$208.93	$389.05
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $117.49 / $117.49	Professional		$117.49	$117.49	$117.49
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $2,511.89 / $2,511.89 / $2,511.89	Facility		$2,511.89	$2,511.89	$2,511.89
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $229.09 / $229.09	Professional		$229.09	$229.09	$229.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $575.44 / $1,202.26	Facility		$302.00	$575.44	$1,202.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $275.42 / $524.81	Professional		$154.88	$275.42	$524.81
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $275.42 / $501.19	Professional		$186.21	$275.42	$501.19
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $10,232.93 / $25,118.86	Facility		$138.04	$10,232.93	$25,118.86
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $208.93 / $263.03	Professional		$208.93	$208.93	$263.03
United Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $263.03 / $537.03	Facility		$123.03	$263.03	$537.03
United Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $158.49 / $316.23	Professional		$104.71	$158.49	$316.23