Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.69 / $94.41 / $153.18	Professional		$52.69	$94.41	$153.18
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $94.41 / $133.47 / $143.22	Professional	25	$94.41	$133.47	$143.22
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $115.50 / $127.08 / $136.63	Professional		$115.50	$127.08	$136.63
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $109.58 / $157.13 / $287.55	Professional		$109.58	$157.13	$287.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $101.15 / $241.46	Professional		$50.00	$101.15	$241.46
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $55.00 / $111.18 / $187.20	Professional		$55.00	$111.18	$187.20
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $252.85 / $252.85 / $283.51	Facility		$252.85	$252.85	$283.51
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $92.17 / $111.73 / $184.36	Professional		$92.17	$111.73	$184.36
United Facility/Professional Professional Modifier Low / Median / High Price $54.43 / $81.83 / $195.20	Professional		$54.43	$81.83	$195.20