Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $177.83 / $812.83	Facility		$169.82	$177.83	$812.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $107.15 / $134.90	Professional		$79.43	$107.15	$134.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $295.12 / $616.60	Facility		$154.88	$295.12	$616.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $107.15 / $107.15	Professional		$107.15	$107.15	$107.15
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $181.97 / $288.40	Professional		$141.25	$181.97	$288.40
Horizon BCBS Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $9,332.54 / $25,118.86	Facility		$134.90	$9,332.54	$25,118.86
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $128.82 / $138.04	Professional		$107.15	$128.82	$138.04
United Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $134.90 / $275.42	Facility		$63.10	$134.90	$275.42
United Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $81.28 / $141.25	Professional		$53.70	$81.28	$141.25