Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $128.84 / $164.59 / $375.56	Facility		$128.84	$164.59	$375.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $164.60 / $164.60 / $164.60	Professional		$164.60	$164.60	$164.60
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $183.25 / $183.25 / $183.25	Professional		$183.25	$183.25	$183.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $149.52 / $175.41 / $193.50	Facility		$149.52	$175.41	$193.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $175.41 / $175.41 / $175.41	Professional		$175.41	$175.41	$175.41
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $8,702.00 / $13,785.00 / $13,785.00	Facility		$8,702.00	$13,785.00	$13,785.00
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $141.85 / $158.97 / $158.97	Professional		$141.85	$158.97	$158.97
United Facility/Professional Professional Modifier Low / Median / High Price $156.69 / $172.37 / $187.09	Professional		$156.69	$172.37	$187.09