Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $102.80 / $102.80 / $102.80	Facility		$102.80	$102.80	$102.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.45 / $100.38 / $102.80	Professional		$83.45	$100.38	$102.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $102.80 / $102.80 / $133.03	Facility		$102.80	$102.80	$133.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.80 / $102.80 / $102.80	Professional		$102.80	$102.80	$102.80
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $92.52 / $102.80 / $102.80	Professional		$92.52	$102.80	$102.80
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $100.38 / $13,785.00 / $13,785.00	Facility		$100.38	$13,785.00	$13,785.00
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $102.80 / $102.80 / $102.80	Professional		$102.80	$102.80	$102.80
United Facility/Professional Professional Modifier Low / Median / High Price $100.78 / $100.78 / $108.96	Professional		$100.78	$100.78	$108.96