Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $295.12 / $575.44	Facility		$104.71	$295.12	$575.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $81.28 / $177.83	Professional		$61.66	$81.28	$177.83
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $251.19 / $354.81 / $1,778.28	Facility		$251.19	$354.81	$1,778.28
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $13.49 / $13.49 / $13.49	Professional		$13.49	$13.49	$13.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $204.17 / $416.87	Facility		$104.71	$204.17	$416.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $107.15 / $186.21	Professional		$57.54	$107.15	$186.21
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $104.71 / $173.78	Professional		$54.95	$104.71	$173.78
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $10,471.29 / $25,118.86	Facility		$91.20	$10,471.29	$25,118.86
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $72.44 / $91.20	Professional		$72.44	$72.44	$91.20
United Facility/Professional Facility Modifier Low / Median / High Price $42.66 / $91.20 / $186.21	Facility		$42.66	$91.20	$186.21
United Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $54.95 / $125.89	Professional		$38.02	$54.95	$125.89