Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $34.65 / $34.65 / $34.65	Facility		$34.65	$34.65	$34.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.80 / $33.19 / $47.23	Professional		$22.80	$33.19	$47.23
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $39.76 / $41.27 / $50.21	Professional	25	$39.76	$41.27	$50.21
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $10.72 / $14.72 / $20.52	Professional	52	$10.72	$14.72	$20.52
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $36.54 / $42.51 / $42.51	Professional		$36.54	$42.51	$42.51
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $35.18 / $35.18 / $36.54	Professional	25	$35.18	$35.18	$36.54
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $41.95 / $43.05 / $58.74	Professional		$41.95	$43.05	$58.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $35.77 / $35.77 / $35.77	Facility		$35.77	$35.77	$35.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.82 / $34.82 / $34.82	Professional		$34.82	$34.82	$34.82
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $45.43 / $55.69 / $77.56	Professional		$45.43	$55.69	$77.56
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $31.21 / $216.59 / $456.72	Facility		$31.21	$216.59	$456.72
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $31.77 / $37.38 / $38.65	Professional		$31.77	$37.38	$38.65
United Facility/Professional Professional Modifier Low / Median / High Price $26.11 / $40.40 / $75.86	Professional		$26.11	$40.40	$75.86