Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $84.35 / $868.86 / $2,875.70	Facility		$84.35	$868.86	$2,875.70
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $376.08 / $1,243.53 / $3,595.51	Facility	25	$376.08	$1,243.53	$3,595.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.15 / $110.79 / $181.25	Professional		$77.15	$110.79	$181.25
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $97.82 / $177.54 / $341.33	Professional	25	$97.82	$177.54	$341.33
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $125.59 / $313.98 / $466.84	Professional		$125.59	$313.98	$466.84
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $111.54 / $202.06 / $460.36	Professional	25	$111.54	$202.06	$460.36
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $122.77 / $242.89 / $965.70	Professional		$122.77	$242.89	$965.70
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,605.00 / $2,040.00 / $2,149.00	Facility		$1,605.00	$2,040.00	$2,149.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $90.13 / $169.61 / $348.98	Professional		$90.13	$169.61	$348.98
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $134.44 / $172.06 / $346.49	Professional		$134.44	$172.06	$346.49
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,035.26 / $1,035.26 / $1,035.26	Facility		$1,035.26	$1,035.26	$1,035.26
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $96.44 / $137.16 / $247.75	Professional		$96.44	$137.16	$247.75
United Facility/Professional Professional Modifier Low / Median / High Price $81.77 / $128.10 / $236.68	Professional		$81.77	$128.10	$236.68