Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $209.47 / $4,118.00 / $9,842.00	Facility		$209.47	$4,118.00	$9,842.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $157.10 / $159.38 / $214.67	Facility	54	$157.10	$159.38	$214.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $193.54 / $228.46 / $404.53	Professional		$193.54	$228.46	$404.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $229.73 / $320.25 / $686.09	Professional		$229.73	$320.25	$686.09
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $221.90 / $321.30 / $399.30	Professional		$221.90	$321.30	$399.30
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $486.18 / $583.20 / $1,264.67	Facility		$486.18	$583.20	$1,264.67
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $212.49 / $270.10 / $568.39	Professional		$212.49	$270.10	$568.39
United Facility/Professional Facility Modifier Low / Median / High Price $1,529.00 / $3,352.00 / $10,536.00	Facility		$1,529.00	$3,352.00	$10,536.00
United Facility/Professional Professional Modifier Low / Median / High Price $194.84 / $275.38 / $641.41	Professional		$194.84	$275.38	$641.41