Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $205.70 / $205.70 / $205.70	Facility		$205.70	$205.70	$205.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $193.60 / $205.70 / $205.70	Professional		$193.60	$205.70	$205.70
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $967.00 / $967.00 / $967.00	Facility		$967.00	$967.00	$967.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $205.70 / $205.70 / $205.70	Facility		$205.70	$205.70	$205.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $205.70 / $205.70 / $205.70	Professional		$205.70	$205.70	$205.70
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $111.02 / $205.70 / $205.70	Professional		$111.02	$205.70	$205.70
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $205.70 / $205.70 / $205.70	Facility		$205.70	$205.70	$205.70
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $193.60 / $205.70 / $205.70	Professional		$193.60	$205.70	$205.70
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $205.70 / $205.70 / $205.70	Facility		$205.70	$205.70	$205.70
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $205.70 / $205.70 / $205.70	Professional		$205.70	$205.70	$205.70
United Facility/Professional Professional Modifier Low / Median / High Price $220.00 / $220.00 / $287.10	Professional		$220.00	$220.00	$287.10