Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $251.19 / $933.25	Facility		$117.49	$251.19	$933.25
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $660.69 / $660.69 / $1,202.26	Facility	25	$660.69	$660.69	$1,202.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $229.09 / $575.44	Professional		$134.90	$229.09	$575.44
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $169.82 / $302.00 / $691.83	Professional	25	$169.82	$302.00	$691.83
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $208.93 / $302.00	Professional		$158.49	$208.93	$302.00
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $173.78 / $213.80 / $263.03	Professional	25	$173.78	$213.80	$263.03
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $794.33 / $794.33 / $794.33	Facility		$794.33	$794.33	$794.33
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $281.84 / $602.56	Professional		$194.98	$281.84	$602.56
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 $154.88 / $234.42 / $407.38	Professional		$154.88	$234.42	$407.38
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $114.82 / $467.74	Professional		$97.72	$114.82	$467.74
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $245.47 / $380.19	Professional		$169.82	$245.47	$380.19
United Facility/Professional Facility Modifier Low / Median / High Price $234.42 / $234.42 / $234.42	Facility		$234.42	$234.42	$234.42
United Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $194.98 / $338.84	Professional		$123.03	$194.98	$338.84