Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $64.45 / $64.80 / $100.01	Facility		$64.45	$64.80	$100.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.84 / $64.45 / $108.83	Professional		$54.84	$64.45	$108.83
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $183.48 / $209.60 / $245.55	Professional	25	$183.48	$209.60	$245.55
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $70.59 / $70.59 / $70.59	Professional		$70.59	$70.59	$70.59
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $67.56 / $67.56 / $94.64	Professional	25	$67.56	$67.56	$94.64
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $76.75 / $76.75 / $76.75	Professional		$76.75	$76.75	$76.75
Cigna Facility/Professional Facility Modifier Low / Median / High Price $86.21 / $86.21 / $94.80	Facility		$86.21	$86.21	$94.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.37 / $90.07 / $137.30	Professional		$54.37	$90.07	$137.30
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $81.22 / $103.30 / $136.43	Professional		$81.22	$103.30	$136.43
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $68.84 / $86.75 / $128.94	Professional		$68.84	$86.75	$128.94
United Facility/Professional Professional Modifier Low / Median / High Price $53.89 / $77.34 / $140.16	Professional		$53.89	$77.34	$140.16
United Facility/Professional Professional Modifier 25 Low / Median / High Price $94.07 / $94.07 / $94.07	Professional	25	$94.07	$94.07	$94.07