Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $51.29 / $114.82 / $338.84	Facility		$51.29	$114.82	$338.84
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $64.57 / $154.88 / $446.68	Facility	25	$64.57	$154.88	$446.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $120.23 / $302.00	Professional		$52.48	$120.23	$302.00
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $60.26 / $125.89 / $331.13	Professional	25	$60.26	$125.89	$331.13
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $95.50 / $234.42 / $309.03	Professional	50	$95.50	$234.42	$309.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $123.03 / $169.82	Professional		$83.18	$123.03	$169.82
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $91.20 / $123.03 / $165.96	Professional	25	$91.20	$123.03	$165.96
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $426.58 / $426.58 / $426.58	Facility		$426.58	$426.58	$426.58
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $162.18 / $281.84	Professional		$100.00	$162.18	$281.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $169.82 / $257.04	Facility		$79.43	$169.82	$257.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $123.03 / $223.87	Professional		$70.79	$123.03	$223.87
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $53.70 / $263.03	Professional		$45.71	$53.70	$263.03
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $134.90 / $208.93	Professional		$91.20	$134.90	$208.93
United Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $134.90 / $134.90	Facility		$134.90	$134.90	$134.90
United Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $100.00 / $173.78	Professional		$57.54	$100.00	$173.78