Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $6.31 / $20.42 / $489.78	Facility		$6.31	$20.42	$489.78
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $218.78 / $446.68 / $691.83	Facility	25	$218.78	$446.68	$691.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $7.08 / $21.88 / $54.95	Professional		$7.08	$21.88	$54.95
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $18.20 / $33.88 / $74.13	Professional	25	$18.20	$33.88	$74.13
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $8.32 / $21.38 / $30.90	Professional		$8.32	$21.38	$30.90
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $17.78 / $21.88 / $25.70	Professional	25	$17.78	$21.88	$25.70
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $181.97 / $181.97 / $181.97	Facility		$181.97	$181.97	$181.97
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $9.55 / $32.36 / $60.26	Professional		$9.55	$32.36	$60.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $21.88 / $169.82 / $269.15	Facility		$21.88	$169.82	$269.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $9.33 / $21.88 / $39.81	Professional		$9.33	$21.88	$39.81
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $25.70 / $47.86	Professional		$21.88	$25.70	$47.86
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,089.30 / $13,803.84 / $19,498.45	Facility		$2,089.30	$13,803.84	$19,498.45
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $17.38 / $26.92 / $43.65	Professional		$17.38	$26.92	$43.65
United Facility/Professional Facility Modifier Low / Median / High Price $24.55 / $24.55 / $24.55	Facility		$24.55	$24.55	$24.55
United Facility/Professional Professional Modifier Low / Median / High Price $7.08 / $17.38 / $33.88	Professional		$7.08	$17.38	$33.88