Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $164.25 / $200.75 / $447.20	Facility		$164.25	$200.75	$447.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $164.25 / $164.25 / $179.04	Professional		$164.25	$164.25	$179.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $154.96 / $164.25 / $205.47	Facility		$154.96	$164.25	$205.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $164.25 / $164.25 / $170.45	Professional		$164.25	$164.25	$170.45
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $159.91 / $159.91 / $200.40	Professional		$159.91	$159.91	$200.40
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $273.64 / $353.68 / $13,785.00	Facility		$273.64	$353.68	$13,785.00
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $137.86 / $148.84 / $158.94	Professional		$137.86	$148.84	$158.94
United Facility/Professional Professional Modifier Low / Median / High Price $164.25 / $172.46 / $190.71	Professional		$164.25	$172.46	$190.71