Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $793.42 / $793.42 / $1,007.64	Facility		$793.42	$793.42	$1,007.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $746.74 / $793.42 / $793.42	Professional		$746.74	$793.42	$793.42
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $5,276.21 / $6,207.30 / $9,310.95	Facility		$5,276.21	$6,207.30	$9,310.95
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $6,207.30 / $6,207.30 / $6,207.30	Professional		$6,207.30	$6,207.30	$6,207.30
Cigna Facility/Professional Facility Modifier Low / Median / High Price $793.42 / $793.42 / $793.42	Facility		$793.42	$793.42	$793.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $793.42 / $793.42 / $793.42	Professional		$793.42	$793.42	$793.42
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $38,249.62 / $38,249.62 / $38,249.62	Professional		$38,249.62	$38,249.62	$38,249.62
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $793.42 / $1,007.64 / $1,134.58	Facility		$793.42	$1,007.64	$1,134.58
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $746.74 / $793.42 / $1,007.64	Professional		$746.74	$793.42	$1,007.64
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $793.42 / $793.42 / $793.42	Facility		$793.42	$793.42	$793.42
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $793.42 / $793.42 / $793.42	Professional		$793.42	$793.42	$793.42
United Facility/Professional Professional Modifier Low / Median / High Price $777.86 / $777.86 / $1,015.11	Professional		$777.86	$777.86	$1,015.11