Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $57.88 / $294.68 / $474.14	Facility		$57.88	$294.68	$474.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $294.69 / $294.69 / $297.64	Professional		$294.69	$294.69	$297.64
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $199.32 / $199.32 / $199.32	Facility		$199.32	$199.32	$199.32
Cigna Facility/Professional Facility Modifier Low / Median / High Price $97.94 / $131.46 / $294.69	Facility		$97.94	$131.46	$294.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $294.69 / $294.69 / $294.69	Professional		$294.69	$294.69	$294.69
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $421.09 / $1,250.22 / $13,785.00	Facility		$421.09	$1,250.22	$13,785.00
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $158.74 / $201.65 / $201.65	Professional		$158.74	$201.65	$201.65
United Facility/Professional Professional Modifier Low / Median / High Price $294.69 / $294.69 / $361.13	Professional		$294.69	$294.69	$361.13