Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $112.45 / $778.51 / $3,072.21	Facility		$112.45	$778.51	$3,072.21
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $515.13 / $1,332.00 / $4,301.09	Facility	25	$515.13	$1,332.00	$4,301.09
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $175.43 / $222.78 / $573.66	Professional	25	$175.43	$222.78	$573.66
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $166.53 / $416.70 / $672.05	Professional	25	$166.53	$416.70	$672.05
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $4,852.43 / $4,852.43 / $4,852.43	Facility		$4,852.43	$4,852.43	$4,852.43
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
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,202.89 / $1,202.89 / $1,490.57	Facility		$1,202.89	$1,202.89	$1,490.57