Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $131.83 / $213.80	Facility		$120.23	$131.83	$213.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $151.36 / $501.19	Professional		$138.04	$151.36	$501.19
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $147.91 / $154.88	Professional		$117.49	$147.91	$154.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $165.96 / $194.98	Facility		$151.36	$165.96	$194.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $165.96 / $165.96	Professional		$38.90	$165.96	$165.96
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $11,481.54 / $25,118.86	Facility		$165.96	$11,481.54	$25,118.86
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $158.49 / $158.49	Professional		$158.49	$158.49	$158.49
United Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $154.88 / $154.88	Facility		$154.88	$154.88	$154.88
United Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $162.18 / $186.21	Professional		$147.91	$162.18	$186.21