Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $151.27 / $151.27 / $151.27	Facility		$151.27	$151.27	$151.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $122.80 / $147.72 / $151.27	Professional		$122.80	$147.72	$151.27
Cigna Facility/Professional Facility Modifier Low / Median / High Price $151.27 / $151.27 / $151.27	Facility		$151.27	$151.27	$151.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $151.27 / $151.27 / $151.27	Professional		$151.27	$151.27	$151.27
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $121.71 / $151.27 / $151.27	Professional		$121.71	$151.27	$151.27
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $13,785.00 / $13,785.00 / $13,785.00	Facility		$13,785.00	$13,785.00	$13,785.00
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $151.27 / $151.27 / $151.27	Professional		$151.27	$151.27	$151.27
United Facility/Professional Professional Modifier Low / Median / High Price $161.79 / $161.79 / $177.97	Professional		$161.79	$161.79	$177.97