Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $64.26 / $122.50 / $482.17	Facility		$64.26	$122.50	$482.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $102.48 / $106.32 / $108.89	Professional		$102.48	$106.32	$108.89
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $113.73 / $242.63 / $242.63	Professional		$113.73	$242.63	$242.63
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $108.89 / $455.33 / $2,444.26	Facility		$108.89	$455.33	$2,444.26
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $124.53 / $124.53 / $129.72	Professional		$124.53	$124.53	$129.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $81.45 / $95.82 / $109.99	Facility		$81.45	$95.82	$109.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.99 / $109.99 / $109.99	Professional		$109.99	$109.99	$109.99
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $134.66 / $134.66 / $134.66	Professional		$134.66	$134.66	$134.66
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $84.00 / $84.00 / $84.00	Professional		$84.00	$84.00	$84.00
United Facility/Professional Professional Modifier Low / Median / High Price $450.58 / $450.58 / $468.78	Professional		$450.58	$450.58	$468.78