Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $20.87 / $126.97 / $549.87	Facility		$20.87	$126.97	$549.87
Aetna Facility/Professional Facility Modifier CQ Low / Median / High Price $65.95 / $240.00 / $532.02	Facility	CQ	$65.95	$240.00	$532.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.40 / $22.33 / $35.04	Professional		$14.40	$22.33	$35.04
Aetna Facility/Professional Professional Modifier CQ Low / Median / High Price $31.41 / $31.41 / $31.41	Professional	CQ	$31.41	$31.41	$31.41
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $48.37 / $93.60 / $195.75	Facility		$48.37	$93.60	$195.75
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $21.71 / $30.31 / $85.32	Professional		$21.71	$30.31	$85.32
AmeriHealth Facility/Professional Professional Modifier CQ Low / Median / High Price $29.22 / $35.75 / $106.65	Professional	CQ	$29.22	$35.75	$106.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $80.00 / $163.65 / $163.65	Facility		$80.00	$163.65	$163.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.60 / $68.36 / $113.16	Professional		$30.60	$68.36	$113.16
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $55.00 / $94.00	Professional		$45.00	$55.00	$94.00
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $25.78 / $30.33 / $39.03	Professional		$25.78	$30.33	$39.03
United Facility/Professional Professional Modifier Low / Median / High Price $22.24 / $35.74 / $42.97	Professional		$22.24	$35.74	$42.97