Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $102.85 / $102.85 / $102.85	Facility		$102.85	$102.85	$102.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.49 / $100.43 / $102.85	Professional		$83.49	$100.43	$102.85
Cigna Facility/Professional Facility Modifier Low / Median / High Price $102.85 / $112.20 / $145.19	Facility		$102.85	$112.20	$145.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.85 / $102.85 / $102.85	Professional		$102.85	$102.85	$102.85
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $102.85 / $108.90 / $108.90	Professional		$102.85	$108.90	$108.90
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $100.43 / $13,785.00 / $13,785.00	Facility		$100.43	$13,785.00	$13,785.00
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $102.85 / $102.85 / $102.85	Professional		$102.85	$102.85	$102.85
United Facility/Professional Professional Modifier Low / Median / High Price $110.00 / $110.00 / $118.93	Professional		$110.00	$110.00	$118.93