Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3.10 / $4.59 / $49.09	Facility		$3.10	$4.59	$49.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $3.10 / $3.10 / $3.13	Professional		$3.10	$3.10	$3.13
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $13.49 / $13.49 / $13.77	Facility		$13.49	$13.49	$13.77
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2.71 / $3.10 / $3.51	Facility		$2.71	$3.10	$3.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3.10 / $3.10 / $3.10	Professional		$3.10	$3.10	$3.10
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 $3.05 / $3.16 / $3.16	Professional		$3.05	$3.16	$3.16
United Facility/Professional Facility Modifier Low / Median / High Price $5.19 / $5.19 / $5.19	Facility		$5.19	$5.19	$5.19
United Facility/Professional Professional Modifier Low / Median / High Price $3.10 / $3.10 / $3.91	Professional		$3.10	$3.10	$3.91