Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $106.15 / $106.15 / $145.10	Facility		$106.15	$106.15	$145.10
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $221.50 / $221.50 / $281.86	Facility	25	$221.50	$221.50	$281.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.31 / $117.48 / $166.99	Professional		$70.31	$117.48	$166.99
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $78.18 / $140.88 / $207.12	Professional	25	$78.18	$140.88	$207.12
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $111.56 / $135.75 / $140.93	Professional		$111.56	$135.75	$140.93
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $124.36 / $140.93 / $140.93	Professional	25	$124.36	$140.93	$140.93
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $129.57 / $180.14 / $320.43	Professional		$129.57	$180.14	$320.43
Cigna Facility/Professional Facility Modifier Low / Median / High Price $90.00 / $90.00 / $146.59	Facility		$90.00	$90.00	$146.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $116.36 / $116.36 / $116.36	Professional		$116.36	$116.36	$116.36
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $150.41 / $184.62 / $253.24	Professional		$150.41	$184.62	$253.24
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $103.93 / $122.27 / $126.70	Professional		$103.93	$122.27	$126.70
United Facility/Professional Professional Modifier Low / Median / High Price $92.96 / $130.88 / $232.50	Professional		$92.96	$130.88	$232.50