Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $92.71 / $101.22 / $3,042.77	Facility		$92.71	$101.22	$3,042.77
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $700.34 / $700.34 / $700.34	Facility	25	$700.34	$700.34	$700.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $84.15 / $102.44 / $190.11	Professional		$84.15	$102.44	$190.11
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $21.19 / $148.55 / $270.64	Professional	25	$21.19	$148.55	$270.64
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $86.10 / $103.01 / $379.07	Professional		$86.10	$103.01	$379.07
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $97.84 / $117.33 / $320.19	Professional	25	$97.84	$117.33	$320.19
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $107.56 / $253.69 / $537.42	Professional		$107.56	$253.69	$537.42
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 $92.31 / $148.62 / $292.56	Professional		$92.31	$148.62	$292.56
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $133.58 / $173.35 / $321.93	Professional		$133.58	$173.35	$321.93
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $102.32 / $143.11 / $255.44	Professional		$102.32	$143.11	$255.44
United Facility/Professional Professional Modifier Low / Median / High Price $85.57 / $128.19 / $239.85	Professional		$85.57	$128.19	$239.85
United Facility/Professional Professional Modifier 25 Low / Median / High Price $80.00 / $80.00 / $144.66	Professional	25	$80.00	$80.00	$144.66