Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $151.36 / $245.47	Facility		$100.00	$151.36	$245.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $165.96 / $478.63	Professional		$112.20	$165.96	$478.63
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $154.88 / $199.53	Professional		$134.90	$154.88	$199.53
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $263.03 / $501.19	Professional		$158.49	$263.03	$501.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $173.78 / $204.17	Facility		$158.49	$173.78	$204.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $208.93 / $346.74	Professional		$131.83	$208.93	$346.74
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $223.87 / $354.81	Professional		$114.82	$223.87	$354.81
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $204.17 / $338.84	Professional		$154.88	$204.17	$338.84
United Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $169.82 / $169.82	Facility		$169.82	$169.82	$169.82
United Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $177.83 / $302.00	Professional		$120.23	$177.83	$302.00