Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $21.44 / $90.00 / $273.00	Facility		$21.44	$90.00	$273.00
Aetna Facility/Professional Facility Modifier CO Low / Median / High Price $31.65 / $112.96 / $125.00	Facility	CO	$31.65	$112.96	$125.00
Aetna Facility/Professional Facility Modifier CQ Low / Median / High Price $178.00 / $197.00 / $394.00	Facility	CQ	$178.00	$197.00	$394.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.40 / $21.65 / $34.11	Professional		$14.40	$21.65	$34.11
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $87.55 / $104.21 / $217.50	Facility		$87.55	$104.21	$217.50
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $20.93 / $27.87 / $70.38	Professional		$20.93	$27.87	$70.38
AmeriHealth Facility/Professional Professional Modifier CQ Low / Median / High Price $31.30 / $31.30 / $31.83	Professional	CQ	$31.30	$31.30	$31.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $80.00 / $80.00 / $80.00	Facility		$80.00	$80.00	$80.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.08 / $68.93 / $113.94	Professional		$32.08	$68.93	$113.94
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $55.00 / $92.55	Professional		$45.00	$55.00	$92.55
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $25.09 / $29.52 / $40.64	Professional		$25.09	$29.52	$40.64
United Facility/Professional Professional Modifier Low / Median / High Price $22.66 / $33.89 / $41.87	Professional		$22.66	$33.89	$41.87