Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $20.00 / $20.00 / $25.40	Facility		$20.00	$20.00	$25.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.00 / $20.00 / $20.00	Professional		$20.00	$20.00	$20.00
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $1,183.65 / $1,860.44 / $3,181.85	Facility		$1,183.65	$1,860.44	$3,181.85
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $967.00 / $57,255.43 / $79,506.39	Facility		$967.00	$57,255.43	$79,506.39
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $28.79 / $29.88 / $29.88	Professional		$28.79	$29.88	$29.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $38.00 / $38.00 / $38.00	Facility		$38.00	$38.00	$38.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $18.70 / $18.70 / $18.70	Professional		$18.70	$18.70	$18.70
Independence Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $1,183.65 / $1,499.59 / $2,534.25	Facility		$1,183.65	$1,499.59	$2,534.25
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $20.00 / $20.00 / $25.40	Facility		$20.00	$20.00	$25.40
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $20.00 / $20.00 / $20.00	Professional		$20.00	$20.00	$20.00
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $477.20 / $493.10 / $1,003.93	Facility		$477.20	$493.10	$1,003.93
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $86.40 / $86.40 / $86.40	Professional		$86.40	$86.40	$86.40
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $38.00 / $38.00 / $38.00	Facility		$38.00	$38.00	$38.00
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $18.70 / $18.70 / $18.70	Professional		$18.70	$18.70	$18.70