Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $107.96 / $212.46 / $988.02	Facility		$107.96	$212.46	$988.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.97 / $138.18 / $173.16	Professional		$107.97	$138.18	$173.16
Cigna Facility/Professional Facility Modifier Low / Median / High Price $168.84 / $381.08 / $791.51	Facility		$168.84	$381.08	$791.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $103.55 / $188.67 / $370.78	Professional		$103.55	$188.67	$370.78
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $120.91 / $181.37 / $250.46	Professional		$120.91	$181.37	$250.46
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $120.91 / $13,785.00 / $13,785.00	Facility		$120.91	$13,785.00	$13,785.00
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $120.91 / $120.91 / $120.91	Professional		$120.91	$120.91	$120.91
United Facility/Professional Facility Modifier Low / Median / High Price $95.00 / $95.00 / $95.00	Facility		$95.00	$95.00	$95.00
United Facility/Professional Professional Modifier Low / Median / High Price $71.30 / $103.64 / $203.72	Professional		$71.30	$103.64	$203.72