Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $91.91 / $91.91 / $91.91	Facility		$91.91	$91.91	$91.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.91 / $132.31 / $196.01	Professional		$91.91	$132.31	$196.01
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $170.76 / $170.76 / $170.76	Professional	25	$170.76	$170.76	$170.76
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $156.49 / $156.49 / $170.46	Professional		$156.49	$156.49	$170.46
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $158.22 / $158.22 / $158.22	Professional	25	$158.22	$158.22	$158.22
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $142.50 / $142.50 / $278.66	Professional		$142.50	$142.50	$278.66
Cigna Facility/Professional Facility Modifier Low / Median / High Price $174.07 / $174.07 / $174.07	Facility		$174.07	$174.07	$174.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $147.90 / $147.90 / $147.90	Professional		$147.90	$147.90	$147.90
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $190.56 / $233.98 / $320.47	Professional		$190.56	$233.98	$320.47
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $313.30 / $313.30 / $313.30	Facility		$313.30	$313.30	$313.30
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $130.76 / $153.83 / $158.69	Professional		$130.76	$153.83	$158.69
United Facility/Professional Professional Modifier Low / Median / High Price $96.19 / $165.77 / $331.52	Professional		$96.19	$165.77	$331.52