Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $178.13 / $178.13 / $178.13	Facility		$178.13	$178.13	$178.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $144.60 / $173.93 / $178.13	Professional		$144.60	$173.93	$178.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $151.41 / $178.13 / $195.94	Facility		$151.41	$178.13	$195.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $178.13 / $178.13 / $178.13	Professional		$178.13	$178.13	$178.13
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $151.41 / $178.13 / $178.13	Professional		$151.41	$178.13	$178.13
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $159.66 / $13,785.00 / $13,785.00	Facility		$159.66	$13,785.00	$13,785.00
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $163.51 / $163.51 / $163.51	Professional		$163.51	$163.51	$163.51
United Facility/Professional Professional Modifier Low / Median / High Price $202.90 / $202.90 / $214.38	Professional		$202.90	$202.90	$214.38