Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $38.02 / $128.82 / $354.81	Facility		$38.02	$128.82	$354.81
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $93.33 / $302.00 / $436.52	Facility	25	$93.33	$302.00	$436.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $85.11 / $194.98	Professional		$46.77	$85.11	$194.98
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $50.12 / $89.13 / $223.87	Professional	25	$50.12	$89.13	$223.87
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $257.04 / $269.15 / $269.15	Professional	50	$257.04	$269.15	$269.15
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $85.11 / $120.23	Professional		$56.23	$85.11	$120.23
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $64.57 / $87.10 / $112.20	Professional	25	$64.57	$87.10	$112.20
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $275.42 / $275.42 / $275.42	Facility		$275.42	$275.42	$275.42
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $104.71 / $186.21	Professional		$69.18	$104.71	$186.21
Cigna Facility/Professional Facility Modifier Low / Median / High Price $56.23 / $173.78 / $269.15	Facility		$56.23	$173.78	$269.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $83.18 / $154.88	Professional		$52.48	$83.18	$154.88
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $53.70 / $173.78	Professional		$45.71	$53.70	$173.78
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $89.13 / $147.91	Professional		$61.66	$89.13	$147.91
United Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $95.50 / $95.50	Facility		$95.50	$95.50	$95.50
United Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $66.07 / $117.49	Professional		$43.65	$66.07	$117.49