Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $99.12 / $204.31 / $3,170.23	Facility		$99.12	$204.31	$3,170.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $99.13 / $99.13 / $100.12	Professional		$99.13	$99.13	$100.12
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $614.46 / $614.46 / $614.46	Facility		$614.46	$614.46	$614.46
Cigna Facility/Professional Facility Modifier Low / Median / High Price $99.13 / $156.90 / $203.05	Facility		$99.13	$156.90	$203.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $99.13 / $99.13 / $99.13	Professional		$99.13	$99.13	$99.13
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $170.60 / $13,785.00 / $13,785.00	Facility		$170.60	$13,785.00	$13,785.00
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $95.25 / $125.12 / $125.12	Professional		$95.25	$125.12	$125.12
United Facility/Professional Professional Modifier Low / Median / High Price $99.13 / $104.58 / $121.48	Professional		$99.13	$104.58	$121.48