Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $253.53 / $274.77 / $392.94	Facility		$253.53	$274.77	$392.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $226.94 / $274.77 / $575.28	Professional		$226.94	$274.77	$575.28
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $353.06 / $415.36 / $8,459.92	Facility		$353.06	$415.36	$8,459.92
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $415.36 / $415.36 / $415.36	Professional		$415.36	$415.36	$415.36
Cigna Facility/Professional Facility Modifier Low / Median / High Price $358.29 / $358.29 / $358.29	Facility		$358.29	$358.29	$358.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $358.29 / $358.29 / $358.29	Professional		$358.29	$358.29	$358.29
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $55.92 / $55.92 / $575.28	Professional		$55.92	$55.92	$575.28
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $253.53 / $274.77 / $654.11	Facility		$253.53	$274.77	$654.11
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $253.53 / $274.77 / $654.11	Professional		$253.53	$274.77	$654.11
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $358.29 / $358.29 / $358.29	Facility		$358.29	$358.29	$358.29
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $358.29 / $358.29 / $358.29	Professional		$358.29	$358.29	$358.29
United Facility/Professional Professional Modifier Low / Median / High Price $676.80 / $676.80 / $883.22	Professional		$676.80	$676.80	$883.22