Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $122.42 / $122.42 / $122.42	Facility		$122.42	$122.42	$122.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $99.11 / $122.42 / $122.42	Professional		$99.11	$122.42	$122.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $104.40 / $112.80 / $130.00	Professional		$104.40	$112.80	$130.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $9.85 / $9.85 / $9.85	Professional		$9.85	$9.85	$9.85
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $122.42 / $122.42 / $122.42	Facility		$122.42	$122.42	$122.42
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $99.11 / $122.42 / $125.48	Professional		$99.11	$122.42	$125.48
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $194.40 / $194.40 / $194.40	Professional		$194.40	$194.40	$194.40
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $9.85 / $9.85 / $9.85	Professional		$9.85	$9.85	$9.85