Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $111.15 / $111.15 / $111.15	Facility		$111.15	$111.15	$111.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $111.15 / $111.15 / $112.26	Professional		$111.15	$111.15	$112.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $111.15 / $371.42 / $480.66	Facility		$111.15	$371.42	$480.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $111.15 / $111.15 / $125.83	Professional		$111.15	$111.15	$125.83
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $94.48 / $111.15 / $164.89	Professional		$94.48	$111.15	$164.89
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $332.42 / $13,785.00 / $13,785.00	Facility		$332.42	$13,785.00	$13,785.00
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $317.83 / $332.42 / $335.16	Professional		$317.83	$332.42	$335.16
United Facility/Professional Professional Modifier Low / Median / High Price $111.15 / $111.15 / $126.98	Professional		$111.15	$111.15	$126.98