Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $97.76 / $136.38 / $644.04	Facility		$97.76	$136.38	$644.04
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $281.75 / $654.50 / $1,211.76	Facility	25	$281.75	$654.50	$1,211.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $120.35 / $179.57 / $335.22	Professional		$120.35	$179.57	$335.22
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $171.23 / $266.20 / $680.36	Professional	25	$171.23	$266.20	$680.36
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $199.62 / $251.04 / $369.55	Professional		$199.62	$251.04	$369.55
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $208.24 / $239.09 / $369.55	Professional	25	$208.24	$239.09	$369.55
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $790.50 / $790.50 / $790.50	Facility		$790.50	$790.50	$790.50
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $223.75 / $308.43 / $483.52	Professional		$223.75	$308.43	$483.52
Cigna Facility/Professional Facility Modifier Low / Median / High Price $135.00 / $170.00 / $223.95	Facility		$135.00	$170.00	$223.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $147.37 / $245.00 / $384.17	Professional		$147.37	$245.00	$384.17
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $80.00 / $195.47 / $378.91	Professional		$80.00	$195.47	$378.91
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $169.00 / $244.14 / $362.90	Professional		$169.00	$244.14	$362.90
United Facility/Professional Professional Modifier Low / Median / High Price $123.61 / $215.52 / $394.45	Professional		$123.61	$215.52	$394.45
United Facility/Professional Professional Modifier 25 Low / Median / High Price $80.00 / $80.00 / $88.00	Professional	25	$80.00	$80.00	$88.00