Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $45.05 / $70.93 / $221.14	Facility		$45.05	$70.93	$221.14
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $265.41 / $309.17 / $309.17	Facility	25	$265.41	$309.17	$309.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $59.92 / $91.58 / $175.00	Professional		$59.92	$91.58	$175.00
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $71.56 / $120.02 / $371.00	Professional	25	$71.56	$120.02	$371.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $103.23 / $122.91 / $194.30	Professional		$103.23	$122.91	$194.30
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $102.67 / $121.44 / $187.30	Professional	25	$102.67	$121.44	$187.30
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $97.55 / $150.41 / $247.15	Professional		$97.55	$150.41	$247.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $102.28 / $150.00 / $206.24	Facility		$102.28	$150.00	$206.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $73.29 / $121.24 / $198.81	Professional		$73.29	$121.24	$198.81
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $67.59 / $100.39 / $220.58	Professional		$67.59	$100.39	$220.58
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $91.45 / $126.00 / $191.57	Professional		$91.45	$126.00	$191.57
United Facility/Professional Professional Modifier Low / Median / High Price $70.97 / $103.33 / $206.51	Professional		$70.97	$103.33	$206.51