Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $251.19 / $1,174.90 / $3,162.28	Facility		$251.19	$1,174.90	$3,162.28
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $223.87 / $954.99 / $3,162.28	Facility	25	$223.87	$954.99	$3,162.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $123.03 / $371.54	Professional		$83.18	$123.03	$371.54
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $100.00 / $223.87 / $512.86	Professional	25	$100.00	$223.87	$512.86
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $131.83 / $316.23	Professional		$109.65	$131.83	$316.23
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $107.15 / $131.83 / $467.74	Professional	25	$107.15	$131.83	$467.74
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $407.38 / $1,071.52	Professional		$147.91	$407.38	$1,071.52
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,659.59 / $2,089.30 / $2,290.87	Facility		$1,659.59	$2,089.30	$2,290.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $162.18 / $323.59	Professional		$93.33	$162.18	$323.59
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $165.96 / $407.38	Professional		$123.03	$165.96	$407.38
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $812.83 / $1,380.38 / $1,737.80	Facility		$812.83	$1,380.38	$1,737.80
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $141.25 / $251.19	Professional		$95.50	$141.25	$251.19
United Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $95.50 / $128.82	Facility		$95.50	$95.50	$128.82
United Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $125.89 / $245.47	Professional		$79.43	$125.89	$245.47