Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $81.28 / $269.15	Professional		$54.95	$81.28	$269.15
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $138.04 / $138.04	Professional		$138.04	$138.04	$138.04
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $269.15 / $281.84	Professional		$186.21	$269.15	$281.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $95.50 / $173.78	Professional		$48.98	$95.50	$173.78
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $91.20 / $117.49	Professional		$58.88	$91.20	$117.49
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $436.52 / $16,218.10 / $19,498.45	Facility		$436.52	$16,218.10	$19,498.45
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $97.72 / $194.98	Professional		$57.54	$97.72	$194.98
United Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $63.10 / $120.23	Professional		$38.90	$63.10	$120.23