Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $375.05 / $4,399.09 / $7,391.13	Facility		$375.05	$4,399.09	$7,391.13
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $101.20 / $187.53 / $2,553.96	Facility	52	$101.20	$187.53	$2,553.96
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $40.47 / $75.01 / $128.86	Facility	53	$40.47	$75.01	$128.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $175.21 / $277.62 / $439.03	Professional		$175.21	$277.62	$439.03
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $37.88 / $75.01 / $168.59	Professional	53	$37.88	$75.01	$168.59
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $172.59 / $194.75 / $335.97	Professional		$172.59	$194.75	$335.97
Ambetter Facility/Professional Professional Modifier 53 Low / Median / High Price $151.01 / $151.01 / $151.01	Professional	53	$151.01	$151.01	$151.01
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $2,337.50 / $2,337.50 / $2,635.00	Facility		$2,337.50	$2,337.50	$2,635.00
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $195.98 / $206.19 / $1,185.80	Professional		$195.98	$206.19	$1,185.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,438.00 / $3,438.00 / $3,438.00	Facility		$3,438.00	$3,438.00	$3,438.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $301.75 / $301.75 / $301.75	Professional		$301.75	$301.75	$301.75
Cigna Facility/Professional Professional Modifier 53 Low / Median / High Price $41.90 / $131.02 / $246.00	Professional	53	$41.90	$131.02	$246.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $350.53 / $486.05 / $673.80	Professional		$350.53	$486.05	$673.80
Emblem Health Facility/Professional Professional Modifier 53 Low / Median / High Price $175.27 / $243.02 / $313.92	Professional	53	$175.27	$243.02	$313.92
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,788.75 / $1,847.80 / $2,216.56	Facility		$1,788.75	$1,847.80	$2,216.56
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $267.67 / $314.89 / $326.63	Professional		$267.67	$314.89	$326.63
United Facility/Professional Facility Modifier Low / Median / High Price $1,882.00 / $3,823.00 / $10,536.00	Facility		$1,882.00	$3,823.00	$10,536.00
United Facility/Professional Professional Modifier Low / Median / High Price $238.94 / $344.39 / $796.58	Professional		$238.94	$344.39	$796.58