Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $5.73 / $14.37 / $271.13	Facility		$5.73	$14.37	$271.13
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $136.94 / $271.13 / $690.12	Facility	25	$136.94	$271.13	$690.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $6.70 / $17.89 / $28.92	Professional		$6.70	$17.89	$28.92
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $15.70 / $30.00 / $39.99	Professional	25	$15.70	$30.00	$39.99
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $9.08 / $25.86 / $41.38	Professional		$9.08	$25.86	$41.38
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $19.00 / $21.71 / $50.00	Professional	25	$19.00	$21.71	$50.00
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $183.95 / $183.95 / $183.95	Facility		$183.95	$183.95	$183.95
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $17.27 / $27.20 / $47.92	Professional		$17.27	$27.20	$47.92
Cigna Facility/Professional Facility Modifier Low / Median / High Price $21.91 / $150.00 / $206.24	Facility		$21.91	$150.00	$206.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $9.11 / $20.68 / $39.92	Professional		$9.11	$20.68	$39.92
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $22.03 / $27.95 / $46.57	Professional		$22.03	$27.95	$46.57
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $17.43 / $25.04 / $41.01	Professional		$17.43	$25.04	$41.01
United Facility/Professional Professional Modifier Low / Median / High Price $17.05 / $23.59 / $44.75	Professional		$17.05	$23.59	$44.75