Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $54.55 / $81.83 / $135.28	Facility		$54.55	$81.83	$135.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.55 / $54.55 / $54.55	Professional		$54.55	$54.55	$54.55
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $45.28 / $53.27 / $8,639.91	Facility		$45.28	$53.27	$8,639.91
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $53.27 / $53.27 / $53.27	Professional		$53.27	$53.27	$53.27
Cigna Facility/Professional Facility Modifier Low / Median / High Price $54.55 / $54.55 / $54.55	Facility		$54.55	$54.55	$54.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.55 / $54.55 / $54.55	Professional		$54.55	$54.55	$54.55
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $54.55 / $81.83 / $135.28	Facility		$54.55	$81.83	$135.28
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $54.55 / $54.55 / $108.55	Professional		$54.55	$54.55	$108.55
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $54.55 / $54.55 / $54.55	Facility		$54.55	$54.55	$54.55
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $54.55 / $54.55 / $54.55	Professional		$54.55	$54.55	$54.55
United Facility/Professional Professional Modifier Low / Median / High Price $56.42 / $56.42 / $97.24	Professional		$56.42	$56.42	$97.24