Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,716.73 / $1,895.46 / $2,255.00	Facility		$1,716.73	$1,895.46	$2,255.00
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $409.19 / $2,141.73 / $2,377.39	Facility	25	$409.19	$2,141.73	$2,377.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.33 / $60.71 / $100.08	Professional		$45.33	$60.71	$100.08
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $70.17 / $142.79 / $219.06	Professional	25	$70.17	$142.79	$219.06
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $73.68 / $179.95 / $240.34	Professional		$73.68	$179.95	$240.34
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $67.29 / $184.20 / $240.34	Professional	25	$67.29	$184.20	$240.34
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $73.17 / $143.05 / $597.60	Professional		$73.17	$143.05	$597.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,194.00 / $1,517.00 / $1,598.00	Facility		$1,194.00	$1,517.00	$1,598.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $55.96 / $94.99 / $191.97	Professional		$55.96	$94.99	$191.97
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $78.59 / $106.41 / $193.33	Professional		$78.59	$106.41	$193.33
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $673.18 / $673.18 / $673.18	Facility		$673.18	$673.18	$673.18
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $50.60 / $73.59 / $140.09	Professional		$50.60	$73.59	$140.09
United Facility/Professional Professional Modifier Low / Median / High Price $48.33 / $69.00 / $133.80	Professional		$48.33	$69.00	$133.80