Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $411.00 / $1,133.55 / $1,478.00	Facility		$411.00	$1,133.55	$1,478.00
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $164.70 / $725.31 / $2,344.00	Facility	25	$164.70	$725.31	$2,344.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.99 / $42.49 / $67.42	Professional		$26.99	$42.49	$67.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $52.45 / $72.11 / $160.71	Professional		$52.45	$72.11	$160.71
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $873.49 / $873.49 / $873.49	Facility		$873.49	$873.49	$873.49
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $43.69 / $109.66 / $379.80	Professional		$43.69	$109.66	$379.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $315.00 / $400.00 / $421.00	Facility		$315.00	$400.00	$421.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.14 / $58.98 / $127.42	Professional		$31.14	$58.98	$127.42
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $46.76 / $59.86 / $115.25	Professional		$46.76	$59.86	$115.25
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $310.69 / $310.69 / $385.01	Facility		$310.69	$310.69	$385.01
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.99 / $47.82 / $88.95	Professional		$33.99	$47.82	$88.95
United Facility/Professional Professional Modifier Low / Median / High Price $25.06 / $44.65 / $89.58	Professional		$25.06	$44.65	$89.58