Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $933.25 / $2,951.21	Facility		$138.04	$933.25	$2,951.21
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $154.88 / $575.44 / $1,819.70	Facility	25	$154.88	$575.44	$1,819.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $69.18 / $204.17	Professional		$51.29	$69.18	$204.17
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $61.66 / $128.82 / $251.19	Professional	25	$61.66	$128.82	$251.19
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $74.13 / $154.88	Professional		$64.57	$74.13	$154.88
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $64.57 / $74.13 / $87.10	Professional	25	$64.57	$74.13	$87.10
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $288.40 / $645.65	Professional		$87.10	$288.40	$645.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,230.27 / $1,513.56 / $1,659.59	Facility		$1,230.27	$1,513.56	$1,659.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $93.33 / $190.55	Professional		$56.23	$93.33	$190.55
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $97.72 / $239.88	Professional		$81.28	$97.72	$239.88
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,096.48 / $6,918.31 / $10,471.29	Facility		$1,096.48	$6,918.31	$10,471.29
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $79.43 / $134.90	Professional		$50.12	$79.43	$134.90
United Facility/Professional Facility Modifier Low / Median / High Price $56.23 / $56.23 / $75.86	Facility		$56.23	$56.23	$75.86
United Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $67.61 / $138.04	Professional		$47.86	$67.61	$138.04