Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $5,248.07 / $8,511.38	Facility		$1,000.00	$5,248.07	$8,511.38
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $1,737.80 / $2,511.89 / $3,162.28	Facility	52	$1,737.80	$2,511.89	$3,162.28
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $57.54 / $109.65 / $257.04	Facility	53	$57.54	$109.65	$257.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $316.23 / $891.25	Professional		$169.82	$316.23	$891.25
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $64.57 / $128.82 / $263.03	Professional	53	$64.57	$128.82	$263.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $173.78 / $234.42	Professional		$158.49	$173.78	$234.42
Ambetter Facility/Professional Professional Modifier 53 Low / Median / High Price $87.10 / $87.10 / $87.10	Professional	53	$87.10	$87.10	$87.10
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $2,511.89 / $2,511.89 / $2,511.89	Facility		$2,511.89	$2,511.89	$2,511.89
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $234.42 / $1,174.90	Professional		$194.98	$234.42	$1,174.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $371.54 / $2,754.23 / $3,630.78	Facility		$371.54	$2,754.23	$3,630.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $302.00 / $302.00	Professional		$302.00	$302.00	$302.00
Cigna Facility/Professional Professional Modifier 53 Low / Median / High Price $41.69 / $131.83 / $245.47	Professional	53	$41.69	$131.83	$245.47
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $537.03 / $776.25	Professional		$398.11	$537.03	$776.25
Emblem Health Facility/Professional Professional Modifier 53 Low / Median / High Price $199.53 / $263.03 / $389.05	Professional	53	$199.53	$263.03	$389.05
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,905.46 / $2,951.21 / $4,677.35	Facility		$1,905.46	$2,951.21	$4,677.35
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $323.59 / $537.03	Professional		$275.42	$323.59	$537.03
United Facility/Professional Facility Modifier Low / Median / High Price $1,778.28 / $3,548.13 / $7,762.47	Facility		$1,778.28	$3,548.13	$7,762.47
United Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $295.12 / $588.84	Professional		$151.36	$295.12	$588.84