Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $79.97 / $199.93 / $699.10	Facility		$79.97	$199.93	$699.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.97 / $101.44 / $128.44	Professional		$79.97	$101.44	$128.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $119.47 / $269.20 / $560.04	Facility		$119.47	$269.20	$560.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $80.73 / $139.18 / $306.33	Professional		$80.73	$139.18	$306.33
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $85.55 / $128.33 / $177.22	Professional		$85.55	$128.33	$177.22
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $6,950.00 / $13,785.00 / $13,785.00	Facility		$6,950.00	$13,785.00	$13,785.00
United Facility/Professional Professional Modifier Low / Median / High Price $51.33 / $73.33 / $150.88	Professional		$51.33	$73.33	$150.88