Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $32.15 / $59.81 / $380.00	Facility		$32.15	$59.81	$380.00
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $204.20 / $300.00 / $628.09	Facility	25	$204.20	$300.00	$628.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.13 / $70.09 / $143.61	Professional		$40.13	$70.09	$143.61
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $47.99 / $94.40 / $243.00	Professional	25	$47.99	$94.40	$243.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $254.64 / $262.68 / $271.76	Professional	50	$254.64	$262.68	$271.76
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $66.28 / $99.26 / $158.82	Professional		$66.28	$99.26	$158.82
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $89.36 / $99.26 / $158.82	Professional	25	$89.36	$99.26	$158.82
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $273.00 / $273.00 / $273.00	Facility		$273.00	$273.00	$273.00
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $70.40 / $108.99 / $181.10	Professional		$70.40	$108.99	$181.10
Cigna Facility/Professional Facility Modifier Low / Median / High Price $56.30 / $150.00 / $206.24	Facility		$56.30	$150.00	$206.24
Cigna Facility/Professional Facility Modifier 62 Low / Median / High Price $55.05 / $55.05 / $55.05	Facility	62	$55.05	$55.05	$55.05
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $8.81 / $8.81 / $8.81	Facility	AS	$8.81	$8.81	$8.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $51.41 / $86.12 / $146.28	Professional		$51.41	$86.12	$146.28
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $42.75 / $103.37 / $151.57	Professional		$42.75	$103.37	$151.57
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $62.19 / $87.07 / $138.30	Professional		$62.19	$87.07	$138.30
United Facility/Professional Professional Modifier Low / Median / High Price $50.18 / $81.58 / $144.13	Professional		$50.18	$81.58	$144.13