Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $142.49 / $265.88 / $1,063.29	Facility		$142.49	$265.88	$1,063.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $131.59 / $142.49 / $177.76	Professional		$131.59	$142.49	$177.76
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $1,672.20 / $1,672.20 / $1,672.20	Facility		$1,672.20	$1,672.20	$1,672.20
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $13.50 / $13.50 / $13.50	Professional		$13.50	$13.50	$13.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $173.26 / $390.46 / $812.22	Facility		$173.26	$390.46	$812.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.24 / $206.62 / $439.60	Professional		$117.24	$206.62	$439.60
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $124.08 / $186.11 / $257.01	Professional		$124.08	$186.11	$257.01
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $124.08 / $13,785.00 / $13,785.00	Facility		$124.08	$13,785.00	$13,785.00
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $124.08 / $124.08 / $124.08	Professional		$124.08	$124.08	$124.08
United Facility/Professional Facility Modifier Low / Median / High Price $97.49 / $97.49 / $97.49	Facility		$97.49	$97.49	$97.49
United Facility/Professional Professional Modifier Low / Median / High Price $74.45 / $106.35 / $241.81	Professional		$74.45	$106.35	$241.81