Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $119.14 / $146.90 / $146.90	Facility		$119.14	$146.90	$146.90
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $67.94 / $67.94 / $67.94	Facility	25	$67.94	$67.94	$67.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $108.12 / $142.15 / $206.29	Professional		$108.12	$142.15	$206.29
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $146.90 / $299.20 / $700.11	Professional	25	$146.90	$299.20	$700.11
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $210.03 / $225.32 / $551.00	Professional		$210.03	$225.32	$551.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $110.25 / $196.72 / $326.10	Professional		$110.25	$196.72	$326.10
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $308.69 / $308.69 / $308.69	Professional		$308.69	$308.69	$308.69
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $261.20 / $283.51 / $679.43	Facility		$261.20	$283.51	$679.43
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $155.53 / $182.98 / $275.17	Professional		$155.53	$182.98	$275.17
United Facility/Professional Professional Modifier Low / Median / High Price $134.97 / $184.01 / $356.45	Professional		$134.97	$184.01	$356.45