Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $45.26 / $73.09 / $445.50	Facility		$45.26	$73.09	$445.50
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $215.43 / $341.46 / $944.09	Facility	25	$215.43	$341.46	$944.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.07 / $99.31 / $209.38	Professional		$56.07	$99.31	$209.38
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $59.61 / $134.24 / $357.00	Professional	25	$59.61	$134.24	$357.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $99.59 / $139.33 / $226.97	Professional		$99.59	$139.33	$226.97
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $118.43 / $139.33 / $222.93	Professional	25	$118.43	$139.33	$222.93
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $428.56 / $428.56 / $428.56	Facility		$428.56	$428.56	$428.56
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $103.40 / $160.00 / $260.00	Professional		$103.40	$160.00	$260.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $82.73 / $150.00 / $218.28	Facility		$82.73	$150.00	$218.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $63.00 / $128.00 / $211.39	Professional		$63.00	$128.00	$211.39
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $143.32 / $217.92	Professional		$45.00	$143.32	$217.92
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $88.49 / $128.16 / $202.31	Professional		$88.49	$128.16	$202.31
United Facility/Professional Professional Modifier Low / Median / High Price $55.08 / $112.33 / $201.17	Professional		$55.08	$112.33	$201.17