Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $20.89 / $21.95 / $43.39	Facility		$20.89	$21.95	$43.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.72 / $24.17 / $42.29	Professional		$20.72	$24.17	$42.29
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $26.97 / $94.80 / $97.21	Professional	25	$26.97	$94.80	$97.21
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $25.94 / $30.62 / $45.20	Professional		$25.94	$30.62	$45.20
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $22.50 / $27.62 / $33.03	Professional	25	$22.50	$27.62	$33.03
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $30.25 / $30.50 / $41.62	Professional		$30.25	$30.50	$41.62
Cigna Facility/Professional Facility Modifier Low / Median / High Price $33.15 / $33.15 / $33.35	Facility		$33.15	$33.15	$33.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $20.58 / $34.06 / $51.46	Professional		$20.58	$34.06	$51.46
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $30.57 / $39.95 / $52.89	Professional		$30.57	$39.95	$52.89
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $58.44 / $69.76 / $147.11	Facility		$58.44	$69.76	$147.11
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $25.49 / $31.71 / $48.09	Professional		$25.49	$31.71	$48.09
United Facility/Professional Professional Modifier Low / Median / High Price $18.54 / $30.00 / $56.54	Professional		$18.54	$30.00	$56.54