Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $75.63 / $92.53 / $152.34	Facility		$75.63	$92.53	$152.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $69.98 / $91.93 / $129.68	Professional		$69.98	$91.93	$129.68
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $145.72 / $145.72 / $145.72	Professional	25	$145.72	$145.72	$145.72
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $67.54 / $90.28 / $113.29	Professional		$67.54	$90.28	$113.29
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $431.25 / $431.25 / $431.25	Facility		$431.25	$431.25	$431.25
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $78.92 / $111.97 / $222.88	Professional		$78.92	$111.97	$222.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $68.00 / $92.00 / $150.46	Professional		$68.00	$92.00	$150.46
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $155.21 / $156.31	Professional		$65.00	$155.21	$156.31
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $315.22 / $315.22 / $390.62	Facility		$315.22	$315.22	$390.62
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $73.23 / $96.36 / $140.44	Professional		$73.23	$96.36	$140.44
United Facility/Professional Professional Modifier Low / Median / High Price $71.23 / $95.35 / $168.75	Professional		$71.23	$95.35	$168.75