Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $185.46 / $274.27 / $2,445.00	Facility		$185.46	$274.27	$2,445.00
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $600.32 / $1,997.69 / $6,653.46	Facility	25	$600.32	$1,997.69	$6,653.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.95 / $223.53 / $432.79	Professional		$169.95	$223.53	$432.79
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $42.16 / $267.79 / $472.18	Professional	25	$42.16	$267.79	$472.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $202.26 / $385.08 / $778.87	Professional		$202.26	$385.08	$778.87
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $202.26 / $214.17 / $657.34	Professional	25	$202.26	$214.17	$657.34
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $224.22 / $375.29 / $1,068.08	Professional		$224.22	$375.29	$1,068.08
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 $201.88 / $320.14 / $625.17	Professional		$201.88	$320.14	$625.17
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $309.14 / $402.14 / $776.63	Professional		$309.14	$402.14	$776.63
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,653.19 / $1,653.19 / $2,048.55	Facility		$1,653.19	$1,653.19	$2,048.55
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $230.31 / $322.55 / $574.48	Professional		$230.31	$322.55	$574.48
United Facility/Professional Professional Modifier Low / Median / High Price $191.53 / $303.13 / $574.29	Professional		$191.53	$303.13	$574.29