Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $125.89 / $316.23	Facility		$75.86	$125.89	$316.23
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $173.78 / $173.78 / $173.78	Facility	25	$173.78	$173.78	$173.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $173.78 / $436.52	Professional		$100.00	$173.78	$436.52
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $112.20 / $194.98 / $467.74	Professional	25	$112.20	$194.98	$467.74
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $162.18 / $229.09	Professional		$114.82	$162.18	$229.09
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $125.89 / $165.96 / $218.78	Professional	25	$125.89	$165.96	$218.78
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $331.13 / $331.13 / $331.13	Facility		$331.13	$331.13	$331.13
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $239.88 / $426.58	Professional		$154.88	$239.88	$426.58
Cigna Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $186.21 / $269.15	Facility		$102.33	$186.21	$269.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $181.97 / $323.59	Professional		$117.49	$181.97	$323.59
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $91.20 / $346.74	Professional		$77.62	$91.20	$346.74
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $194.98 / $302.00	Professional		$141.25	$194.98	$302.00
United Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $173.78 / $173.78	Facility		$173.78	$173.78	$173.78
United Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $151.36 / $263.03	Professional		$97.72	$151.36	$263.03