Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $109.44 / $109.44 / $109.44	Facility		$109.44	$109.44	$109.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.44 / $109.44 / $110.53	Professional		$109.44	$109.44	$110.53
Cigna Facility/Professional Facility Modifier Low / Median / High Price $109.44 / $348.18 / $450.58	Facility		$109.44	$348.18	$450.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.44 / $109.44 / $123.89	Professional		$109.44	$109.44	$123.89
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $108.40 / $109.44 / $162.34	Professional		$108.40	$109.44	$162.34
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 $69.62 / $206.48 / $206.48	Professional		$69.62	$206.48	$206.48
United Facility/Professional Professional Modifier Low / Median / High Price $109.44 / $109.44 / $118.33	Professional		$109.44	$109.44	$118.33