Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $131.83 / $173.78	Facility		$72.44	$131.83	$173.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $125.89 / $186.21	Professional		$95.50	$125.89	$186.21
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $128.82 / $141.25 / $169.82	Professional	25	$128.82	$141.25	$169.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $120.23 / $134.90	Professional		$100.00	$120.23	$134.90
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $128.82 / $128.82 / $128.82	Professional	25	$128.82	$128.82	$128.82
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $134.90 / $134.90	Professional		$134.90	$134.90	$134.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $95.50 / $346.74	Professional		$58.88	$95.50	$346.74
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $131.83 / $194.98	Professional		$107.15	$131.83	$194.98
United Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $109.65 / $151.36	Facility		$104.71	$109.65	$151.36
United Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $114.82 / $204.17	Professional		$81.28	$114.82	$204.17