Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $86.83 / $98.40 / $124.11	Facility		$86.83	$98.40	$124.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.55 / $107.64 / $138.74	Professional		$87.55	$107.64	$138.74
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $73.91 / $105.00 / $106.91	Professional		$73.91	$105.00	$106.91
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $99.37 / $128.08 / $649.90	Professional		$99.37	$128.08	$649.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $88.86 / $119.00 / $198.46	Professional		$88.86	$119.00	$198.46
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $106.76 / $175.47 / $197.47	Professional		$106.76	$175.47	$197.47
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $610.96 / $610.96 / $757.08	Facility		$610.96	$610.96	$757.08
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $81.64 / $115.79 / $194.18	Professional		$81.64	$115.79	$194.18
United Facility/Professional Professional Modifier Low / Median / High Price $93.75 / $128.07 / $221.13	Professional		$93.75	$128.07	$221.13