Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $408.00 / $408.00 / $408.00	Facility		$408.00	$408.00	$408.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $331.20 / $398.40 / $408.00	Professional		$331.20	$398.40	$408.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $408.00 / $489.60 / $633.60	Facility		$408.00	$489.60	$633.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $408.00 / $408.00 / $408.00	Professional		$408.00	$408.00	$408.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $289.00 / $340.00 / $340.00	Professional		$289.00	$340.00	$340.00
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $332.00 / $13,785.00 / $13,785.00	Facility		$332.00	$13,785.00	$13,785.00
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $340.00 / $340.00 / $340.00	Professional		$340.00	$340.00	$340.00
United Facility/Professional Professional Modifier Low / Median / High Price $456.00 / $480.00 / $506.40	Professional		$456.00	$480.00	$506.40