Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $151.36 / $691.83	Facility		$147.91	$151.36	$691.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $91.20 / $138.04	Professional		$61.66	$91.20	$138.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $251.19 / $524.81	Facility		$112.20	$251.19	$524.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $131.83 / $173.78	Professional		$60.26	$131.83	$173.78
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $53.70 / $67.61	Professional		$45.71	$53.70	$67.61
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $9,549.93 / $25,118.86	Facility		$114.82	$9,549.93	$25,118.86
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $83.18 / $91.20	Professional		$69.18	$83.18	$91.20
United Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $114.82 / $234.42	Facility		$53.70	$114.82	$234.42
United Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $69.18 / $117.49	Professional		$44.67	$69.18	$117.49