Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $19.50 / $66.07 / $302.00	Facility		$19.50	$66.07	$302.00
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $141.25 / $269.15 / $295.12	Facility	25	$141.25	$269.15	$295.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $52.48 / $120.23	Professional		$27.54	$52.48	$120.23
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $32.36 / $60.26 / $138.04	Professional	25	$32.36	$60.26	$138.04
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $52.48 / $72.44	Professional		$30.20	$52.48	$72.44
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $40.74 / $54.95 / $69.18	Professional	25	$40.74	$54.95	$69.18
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $43.65 / $43.65 / $43.65	Professional	50	$43.65	$43.65	$43.65
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $69.18 / $131.83	Professional		$38.02	$69.18	$131.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $38.90 / $169.82 / $269.15	Facility		$38.90	$169.82	$269.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $48.98 / $91.20	Professional		$27.54	$48.98	$91.20
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $50.12 / $117.49	Professional		$42.66	$50.12	$117.49
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $56.23 / $91.20	Professional		$41.69	$56.23	$91.20
United Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $60.26 / $60.26	Facility		$60.26	$60.26	$60.26
United Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $39.81 / $69.18	Professional		$21.88	$39.81	$69.18