Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $205.70 / $205.70 / $205.70	Facility		$205.70	$205.70	$205.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $166.98 / $200.86 / $205.70	Professional		$166.98	$200.86	$205.70
Cigna Facility/Professional Facility Modifier Low / Median / High Price $205.70 / $205.70 / $205.70	Facility		$205.70	$205.70	$205.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $205.70 / $205.70 / $205.70	Professional		$205.70	$205.70	$205.70
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $111.02 / $205.70 / $205.70	Professional		$111.02	$205.70	$205.70
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $200.86 / $13,785.00 / $13,785.00	Facility		$200.86	$13,785.00	$13,785.00
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $67.80 / $205.70 / $205.70	Professional		$67.80	$205.70	$205.70
United Facility/Professional Professional Modifier Low / Median / High Price $220.00 / $220.00 / $242.00	Professional		$220.00	$220.00	$242.00