Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $75.98 / $113.99 / $188.46	Facility		$75.98	$113.99	$188.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.98 / $75.98 / $75.98	Professional		$75.98	$75.98	$75.98
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $63.07 / $74.20 / $8,639.91	Facility		$63.07	$74.20	$8,639.91
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $74.20 / $74.20 / $74.20	Professional		$74.20	$74.20	$74.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $75.98 / $75.98 / $75.98	Facility		$75.98	$75.98	$75.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.98 / $75.98 / $75.98	Professional		$75.98	$75.98	$75.98
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $75.98 / $113.99 / $188.46	Facility		$75.98	$113.99	$188.46
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $75.98 / $75.98 / $151.22	Professional		$75.98	$75.98	$151.22
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $75.98 / $75.98 / $75.98	Facility		$75.98	$75.98	$75.98
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $75.98 / $75.98 / $75.98	Professional		$75.98	$75.98	$75.98
United Facility/Professional Facility Modifier Low / Median / High Price $72.00 / $72.00 / $72.00	Facility		$72.00	$72.00	$72.00
United Facility/Professional Professional Modifier Low / Median / High Price $74.50 / $74.50 / $97.22	Professional		$74.50	$74.50	$97.22