Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $39.81 / $74.13 / $93.33	Facility		$39.81	$74.13	$93.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $67.61 / $97.72	Professional		$50.12	$67.61	$97.72
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $14.45 / $72.44 / $107.15	Professional	25	$14.45	$72.44	$107.15
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $67.61 / $77.62	Professional		$57.54	$67.61	$77.62
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $64.57 / $66.07 / $70.79	Professional	25	$64.57	$66.07	$70.79
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $72.44 / $72.44	Professional		$72.44	$72.44	$72.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $52.48 / $177.83	Professional		$38.02	$52.48	$177.83
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $67.61 / $102.33	Professional		$56.23	$67.61	$102.33
United Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $75.86 / $81.28	Facility		$58.88	$75.86	$81.28
United Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $66.07 / $109.65	Professional		$45.71	$66.07	$109.65