Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $27.16 / $43.86 / $198.57	Facility		$27.16	$43.86	$198.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $18.60 / $27.37 / $41.98	Professional		$18.60	$27.37	$41.98
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $17.55 / $17.55 / $17.55	Professional		$17.55	$17.55	$17.55
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $171.43 / $180.12 / $198.66	Facility		$171.43	$180.12	$198.66
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $12.35 / $12.35 / $29.12	Professional		$12.35	$12.35	$29.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $34.40 / $77.23 / $160.79	Facility		$34.40	$77.23	$160.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.49 / $43.37 / $97.97	Professional		$25.49	$43.37	$97.97
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $24.56 / $36.84 / $50.88	Professional		$24.56	$36.84	$50.88
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $24.56 / $13,785.00 / $13,785.00	Facility		$24.56	$13,785.00	$13,785.00
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $24.56 / $24.56 / $24.56	Professional		$24.56	$24.56	$24.56
United Facility/Professional Facility Modifier Low / Median / High Price $19.30 / $19.30 / $19.30	Facility		$19.30	$19.30	$19.30
United Facility/Professional Professional Modifier Low / Median / High Price $14.74 / $21.05 / $51.99	Professional		$14.74	$21.05	$51.99