Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $145.49 / $145.49 / $145.49	Facility		$145.49	$145.49	$145.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $145.49 / $145.49 / $146.94	Professional		$145.49	$145.49	$146.94
Cigna Facility/Professional Facility Modifier Low / Median / High Price $145.49 / $183.60 / $237.60	Facility		$145.49	$183.60	$237.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $145.49 / $145.49 / $164.70	Professional		$145.49	$145.49	$164.70
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $137.25 / $145.49 / $194.40	Professional		$137.25	$145.49	$194.40
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $8,702.00 / $13,785.00 / $13,785.00	Facility		$8,702.00	$13,785.00	$13,785.00
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $91.08 / $135.91 / $135.91	Professional		$91.08	$135.91	$135.91
United Facility/Professional Professional Modifier Low / Median / High Price $145.49 / $145.49 / $160.04	Professional		$145.49	$145.49	$160.04