Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $114.07 / $303.70 / $1,412.38	Facility		$114.07	$303.70	$1,412.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $114.07 / $182.94 / $246.92	Professional		$114.07	$182.94	$246.92
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $177.74 / $671.15 / $3,426.49	Facility		$177.74	$671.15	$3,426.49
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $270.70 / $368.49 / $632.50	Professional		$270.70	$368.49	$632.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $79.95 / $312.36 / $1,131.47	Facility		$79.95	$312.36	$1,131.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $59.04 / $60.16 / $270.93	Professional		$59.04	$60.16	$270.93
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $98.77 / $123.46 / $148.15	Professional		$98.77	$123.46	$148.15
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,165.00 / $8,702.00 / $13,785.00	Facility		$1,165.00	$8,702.00	$13,785.00
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $170.09 / $170.09 / $172.18	Professional		$170.09	$170.09	$172.18
United Facility/Professional Professional Modifier Low / Median / High Price $95.60 / $129.13 / $251.86	Professional		$95.60	$129.13	$251.86