Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $25.37 / $77.48 / $210.60	Facility		$25.37	$77.48	$210.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.02 / $27.37 / $39.34	Professional		$22.02	$27.37	$39.34
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 $34.85 / $145.60 / $300.30	Facility		$34.85	$145.60	$300.30
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $13.50 / $29.12 / $36.84	Professional		$13.50	$29.12	$36.84
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 $16.48 / $35.09 / $72.02	Facility		$16.48	$35.09	$72.02
United Facility/Professional Professional Modifier Low / Median / High Price $14.74 / $21.05 / $49.07	Professional		$14.74	$21.05	$49.07