Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $106.32 / $170.05 / $4,910.14	Facility		$106.32	$170.05	$4,910.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $106.33 / $106.33 / $159.49	Professional		$106.33	$106.33	$159.49
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $136.04 / $163.60 / $163.60	Professional		$136.04	$163.60	$163.60
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $251.75 / $251.75 / $251.75	Professional		$251.75	$251.75	$251.75
Cigna Facility/Professional Facility Modifier Low / Median / High Price $106.33 / $161.16 / $208.57	Facility		$106.33	$161.16	$208.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $106.33 / $106.33 / $110.35	Professional		$106.33	$106.33	$110.35
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $99.00 / $116.47 / $149.13	Professional		$99.00	$116.47	$149.13
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $294.80 / $1,165.00 / $13,785.00	Facility		$294.80	$1,165.00	$13,785.00
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $135.55 / $163.60 / $163.60	Professional		$135.55	$163.60	$163.60
United Facility/Professional Professional Modifier Low / Median / High Price $106.33 / $112.18 / $126.76	Professional		$106.33	$112.18	$126.76