Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $36.26 / $68.80 / $116.66	Facility		$36.26	$68.80	$116.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.26 / $70.76 / $118.93	Professional		$36.26	$70.76	$118.93
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $69.52 / $80.48 / $98.10	Professional	25	$69.52	$80.48	$98.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $71.09 / $83.30 / $87.57	Professional		$71.09	$83.30	$87.57
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $70.44 / $77.83 / $109.76	Professional	25	$70.44	$77.83	$109.76
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $84.81 / $119.42 / $203.18	Professional		$84.81	$119.42	$203.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $99.63 / $99.63 / $100.27	Facility		$99.63	$99.63	$100.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $59.25 / $99.92 / $155.62	Professional		$59.25	$99.92	$155.62
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $93.94 / $119.97 / $157.85	Professional		$93.94	$119.97	$157.85
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $181.48 / $216.59 / $224.89	Facility		$181.48	$216.59	$224.89
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $79.56 / $99.98 / $152.58	Professional		$79.56	$99.98	$152.58
United Facility/Professional Professional Modifier Low / Median / High Price $63.71 / $92.34 / $161.15	Professional		$63.71	$92.34	$161.15
United Facility/Professional Professional Modifier 25 Low / Median / High Price $83.64 / $83.64 / $99.10	Professional	25	$83.64	$83.64	$99.10