Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $239.88 / $977.24	Facility		$120.23	$239.88	$977.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $97.72 / $275.42	Professional		$93.33	$97.72	$275.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $93.33 / $95.50	Professional		$93.33	$93.33	$95.50
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $302.00 / $302.00	Facility		$302.00	$302.00	$302.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $109.65 / $144.54	Facility		$89.13	$109.65	$144.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $93.33 / $93.33	Professional		$93.33	$93.33	$93.33
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $9,549.93 / $25,118.86	Facility		$177.83	$9,549.93	$25,118.86
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $95.50 / $97.72	Professional		$95.50	$95.50	$97.72
United Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $112.20 / $173.78	Facility		$79.43	$112.20	$173.78
United Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $93.33 / $107.15	Professional		$93.33	$93.33	$107.15