Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $89.34 / $128.63 / $4,875.29	Facility		$89.34	$128.63	$4,875.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.34 / $89.34 / $109.16	Professional		$89.34	$89.34	$109.16
Cigna Facility/Professional Facility Modifier Low / Median / High Price $89.34 / $148.25 / $191.85	Facility		$89.34	$148.25	$191.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.34 / $89.34 / $92.72	Professional		$89.34	$89.34	$92.72
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $92.72 / $92.72 / $120.98	Professional		$92.72	$92.72	$120.98
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $153.75 / $399.95 / $13,785.00	Facility		$153.75	$399.95	$13,785.00
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $118.75 / $124.76 / $133.32	Professional		$118.75	$124.76	$133.32
United Facility/Professional Facility Modifier Low / Median / High Price $118.75 / $252.74 / $258.70	Facility		$118.75	$252.74	$258.70
United Facility/Professional Professional Modifier Low / Median / High Price $89.34 / $94.25 / $107.21	Professional		$89.34	$94.25	$107.21