Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $112.32 / $112.32 / $112.32	Facility		$112.32	$112.32	$112.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $78.12 / $112.32 / $112.32	Professional		$78.12	$112.32	$112.32
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $41.29 / $42.50 / $57.50	Professional		$41.29	$42.50	$57.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2.00 / $2.00 / $2.00	Professional		$2.00	$2.00	$2.00
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $112.32 / $112.32 / $112.32	Facility		$112.32	$112.32	$112.32
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $78.12 / $112.32 / $112.32	Professional		$78.12	$112.32	$112.32
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $168.80 / $168.80 / $168.80	Professional		$168.80	$168.80	$168.80
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $2.00 / $2.00 / $2.00	Professional		$2.00	$2.00	$2.00