Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $281.84 / $812.83	Facility		$74.13	$281.84	$812.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $102.33 / $549.54	Professional		$81.28	$102.33	$549.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $87.10 / $162.18	Professional		$69.18	$87.10	$162.18
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $407.38 / $1,621.81	Facility		$147.91	$407.38	$1,621.81
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Professional		$100.00	$100.00	$100.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $87.10 / $112.20	Facility		$87.10	$87.10	$112.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $87.10 / $87.10	Professional		$87.10	$87.10	$87.10
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $100.00 / $100.00	Professional		$85.11	$100.00	$100.00
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $9,549.93 / $15,488.17	Facility		$100.00	$9,549.93	$15,488.17
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Professional		$100.00	$100.00	$100.00
United Facility/Professional Facility Modifier Low / Median / High Price $218.78 / $218.78 / $218.78	Facility		$218.78	$218.78	$218.78
United Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $85.11 / $89.13	Professional		$85.11	$85.11	$89.13