Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $87.28 / $203.44 / $264.30	Facility		$87.28	$203.44	$264.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.28 / $88.16 / $105.20	Professional		$87.28	$88.16	$105.20
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $80.48 / $94.69 / $8,639.91	Facility		$80.48	$94.69	$8,639.91
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $90.58 / $90.58 / $90.58	Professional		$90.58	$90.58	$90.58
Cigna Facility/Professional Facility Modifier Low / Median / High Price $82.34 / $87.28 / $87.28	Facility		$82.34	$87.28	$87.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.28 / $87.28 / $87.28	Professional		$87.28	$87.28	$87.28
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $87.81 / $203.44 / $264.30	Facility		$87.81	$203.44	$264.30
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $87.28 / $88.16 / $264.30	Professional		$87.28	$88.16	$264.30
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $82.34 / $87.28 / $87.28	Facility		$82.34	$87.28	$87.28
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $87.28 / $87.28 / $87.28	Professional		$87.28	$87.28	$87.28
United Facility/Professional Professional Modifier Low / Median / High Price $87.28 / $87.28 / $150.43	Professional		$87.28	$87.28	$150.43