Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $89.34 / $1,621.99 / $4,621.00	Facility		$89.34	$1,621.99	$4,621.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.34 / $89.34 / $90.24	Professional		$89.34	$89.34	$90.24
Cigna Facility/Professional Facility Modifier Low / Median / High Price $89.34 / $158.25 / $204.80	Facility		$89.34	$158.25	$204.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.34 / $89.34 / $89.34	Professional		$89.34	$89.34	$89.34
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $89.91 / $327.33 / $13,785.00	Facility		$89.91	$327.33	$13,785.00
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $19.98 / $19.98 / $167.68	Professional		$19.98	$19.98	$167.68
United Facility/Professional Professional Modifier Low / Median / High Price $89.34 / $99.45 / $109.48	Professional		$89.34	$99.45	$109.48