Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $151.27 / $151.27 / $151.27	Facility		$151.27	$151.27	$151.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $142.38 / $151.27 / $151.27	Professional		$142.38	$151.27	$151.27
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 $151.27 / $151.27 / $151.27	Facility		$151.27	$151.27	$151.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $151.27 / $151.27 / $151.27	Professional		$151.27	$151.27	$151.27
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $121.71 / $151.27 / $151.27	Professional		$121.71	$151.27	$151.27
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $151.27 / $151.27 / $151.27	Facility		$151.27	$151.27	$151.27
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $142.38 / $151.27 / $151.27	Professional		$142.38	$151.27	$151.27
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $151.27 / $151.27 / $151.27	Facility		$151.27	$151.27	$151.27
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $151.27 / $151.27 / $151.27	Professional		$151.27	$151.27	$151.27
United Facility/Professional Professional Modifier Low / Median / High Price $161.79 / $161.79 / $223.43	Professional		$161.79	$161.79	$223.43