Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $106.97 / $106.97 / $106.97	Facility		$106.97	$106.97	$106.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $106.97 / $106.97 / $108.04	Professional		$106.97	$106.97	$108.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $95.25 / $106.97 / $123.27	Facility		$95.25	$106.97	$123.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $106.97 / $106.97 / $111.00	Professional		$106.97	$106.97	$111.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $106.96 / $106.97 / $116.66	Professional		$106.96	$106.97	$116.66
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $37.86 / $13,785.00 / $13,785.00	Facility		$37.86	$13,785.00	$13,785.00
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $37.97 / $37.97 / $99.16	Professional		$37.97	$37.97	$99.16
United Facility/Professional Professional Modifier Low / Median / High Price $106.97 / $106.97 / $115.66	Professional		$106.97	$106.97	$115.66