Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $251.19 / $346.74 / $1,548.82	Facility		$251.19	$346.74	$1,548.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $323.59 / $575.44	Professional		$251.19	$323.59	$575.44
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $354.81 / $416.87 / $5,011.87	Facility		$354.81	$416.87	$5,011.87
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $416.87 / $416.87	Professional		$416.87	$416.87	$416.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $338.84 / $338.84 / $338.84	Facility		$338.84	$338.84	$338.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $338.84 / $338.84	Professional		$338.84	$338.84	$338.84
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $56.23 / $56.23	Professional		$47.86	$56.23	$56.23
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $645.65 / $645.65	Professional		$645.65	$645.65	$645.65
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $251.19 / $346.74 / $1,548.82	Facility		$251.19	$346.74	$1,548.82
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $338.84 / $616.60	Professional		$251.19	$338.84	$616.60
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $0.60 / $0.60 / $0.60	Professional		$0.60	$0.60	$0.60
United Facility/Professional Facility Modifier Low / Median / High Price $1,905.46 / $1,905.46 / $1,905.46	Facility		$1,905.46	$1,905.46	$1,905.46
United Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $676.08 / $851.14	Professional		$645.65	$676.08	$851.14