Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,224.00 / $1,224.00 / $1,224.00	Facility		$1,224.00	$1,224.00	$1,224.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $993.60 / $1,195.20 / $1,224.00	Professional		$993.60	$1,195.20	$1,224.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $489.60 / $633.60 / $1,224.00	Facility		$489.60	$633.60	$1,224.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,224.00 / $1,224.00 / $1,224.00	Professional		$1,224.00	$1,224.00	$1,224.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $437.54 / $1,224.00 / $1,224.00	Professional		$437.54	$1,224.00	$1,224.00
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,243.00 / $13,785.00 / $13,785.00	Facility		$3,243.00	$13,785.00	$13,785.00
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $386.49 / $1,224.00 / $1,224.00	Professional		$386.49	$1,224.00	$1,224.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,200.00 / $1,200.00 / $1,297.44	Professional		$1,200.00	$1,200.00	$1,297.44