Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $19.95 / $19.95 / $21.88	Facility		$19.95	$19.95	$21.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $28.84 / $67.61	Professional		$19.95	$28.84	$67.61
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $8,511.38 / $8,511.38 / $77,624.71	Facility		$8,511.38	$8,511.38	$77,624.71
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $29.51 / $29.51	Professional		$28.18	$29.51	$29.51
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $32.36 / $32.36 / $32.36	Facility		$32.36	$32.36	$32.36
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $15.49 / $20.89 / $30.20	Professional		$15.49	$20.89	$30.20
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $29.51 / $29.51	Professional		$29.51	$29.51	$29.51
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $19.95 / $19.95 / $19.95	Facility		$19.95	$19.95	$19.95
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $28.18 / $64.57	Professional		$19.95	$28.18	$64.57
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $25.70 / $25.70 / $25.70	Facility		$25.70	$25.70	$25.70
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $0.60 / $25.70 / $30.90	Professional		$0.60	$25.70	$30.90
United Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $46.77 / $61.66	Professional		$25.12	$46.77	$61.66