Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $115.20 / $288.00 / $893.04	Facility		$115.20	$288.00	$893.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $103.90 / $142.00 / $173.88	Professional		$103.90	$142.00	$173.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $169.28 / $381.80 / $793.53	Facility		$169.28	$381.80	$793.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $114.76 / $201.86 / $430.45	Professional		$114.76	$201.86	$430.45
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $121.22 / $181.83 / $315.52	Professional		$121.22	$181.83	$315.52
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $121.22 / $13,785.00 / $13,785.00	Facility		$121.22	$13,785.00	$13,785.00
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $121.22 / $121.22 / $121.22	Professional		$121.22	$121.22	$121.22
United Facility/Professional Facility Modifier Low / Median / High Price $95.24 / $95.24 / $95.24	Facility		$95.24	$95.24	$95.24
United Facility/Professional Professional Modifier Low / Median / High Price $76.91 / $147.19 / $222.78	Professional		$76.91	$147.19	$222.78