Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $309.03 / $323.59	Facility		$169.82	$309.03	$323.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $269.15 / $776.25	Professional		$213.80	$269.15	$776.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $229.09 / $338.84	Professional		$173.78	$229.09	$338.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $239.88 / $263.03 / $316.23	Facility		$239.88	$263.03	$316.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $263.03 / $263.03	Professional		$263.03	$263.03	$263.03
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $269.15 / $11,481.54 / $25,118.86	Facility		$269.15	$11,481.54	$25,118.86
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $257.04 / $257.04	Professional		$257.04	$257.04	$257.04
United Facility/Professional Facility Modifier Low / Median / High Price $354.81 / $354.81 / $354.81	Facility		$354.81	$354.81	$354.81
United Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $263.03 / $302.00	Professional		$234.42	$263.03	$302.00