Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $199.53 / $691.83	Facility		$123.03	$199.53	$691.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $100.00 / $125.89	Professional		$81.28	$100.00	$125.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $269.15 / $562.34	Facility		$141.25	$269.15	$562.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $87.10 / $87.10	Professional		$87.10	$87.10	$87.10
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $165.96 / $263.03	Professional		$128.82	$165.96	$263.03
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $9,549.93 / $25,118.86	Facility		$123.03	$9,549.93	$25,118.86
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $117.49 / $123.03	Professional		$95.50	$117.49	$123.03
United Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $123.03 / $251.19	Facility		$57.54	$123.03	$251.19
United Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $72.44 / $154.88	Professional		$51.29	$72.44	$154.88