Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $163.19 / $244.80 / $404.74	Facility		$163.19	$244.80	$404.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $163.19 / $163.19 / $163.19	Professional		$163.19	$163.19	$163.19
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $135.46 / $159.36 / $8,639.91	Facility		$135.46	$159.36	$8,639.91
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $159.36 / $159.36 / $159.36	Professional		$159.36	$159.36	$159.36
Cigna Facility/Professional Facility Modifier Low / Median / High Price $163.19 / $163.19 / $163.19	Facility		$163.19	$163.19	$163.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $163.19 / $163.19 / $163.19	Professional		$163.19	$163.19	$163.19
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $163.19 / $244.80 / $404.74	Facility		$163.19	$244.80	$404.74
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $163.19 / $163.19 / $324.77	Professional		$163.19	$163.19	$324.77
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $163.19 / $163.19 / $163.19	Facility		$163.19	$163.19	$163.19
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $163.19 / $163.19 / $163.19	Professional		$163.19	$163.19	$163.19
United Facility/Professional Professional Modifier Low / Median / High Price $160.00 / $160.00 / $208.80	Professional		$160.00	$160.00	$208.80