Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $104.71 / $309.03	Facility		$66.07	$104.71	$309.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $41.69 / $51.29	Professional		$41.69	$41.69	$51.29
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $38.02 / $38.02 / $38.02	Facility		$38.02	$38.02	$38.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $112.20 / $112.20	Facility		$50.12	$112.20	$112.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $41.69 / $58.88	Professional		$27.54	$41.69	$58.88
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $25.70 / $41.69	Professional		$20.42	$25.70	$41.69
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $11,481.54 / $27,542.29	Facility		$125.89	$11,481.54	$27,542.29
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $30.90 / $30.90	Professional		$30.90	$30.90	$30.90
United Facility/Professional Facility Modifier Low / Median / High Price $23.99 / $42.66 / $87.10	Facility		$23.99	$42.66	$87.10
United Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $25.12 / $44.67	Professional		$18.20	$25.12	$44.67