Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $199.22 / $459.35 / $1,545.10	Facility		$199.22	$459.35	$1,545.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $199.22 / $229.95 / $307.94	Professional		$199.22	$229.95	$307.94
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $1,564.50 / $1,564.50 / $1,564.50	Facility		$1,564.50	$1,564.50	$1,564.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $252.39 / $567.29 / $1,179.73	Facility		$252.39	$567.29	$1,179.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $173.72 / $300.08 / $719.39	Professional		$173.72	$300.08	$719.39
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $180.22 / $270.32 / $373.30	Professional		$180.22	$270.32	$373.30
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $180.22 / $8,702.00 / $13,785.00	Facility		$180.22	$8,702.00	$13,785.00
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $180.22 / $180.22 / $180.22	Professional		$180.22	$180.22	$180.22
United Facility/Professional Professional Modifier Low / Median / High Price $108.13 / $154.47 / $385.28	Professional		$108.13	$154.47	$385.28