Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $575.44 / $1,148.15 / $1,737.80	Facility		$575.44	$1,148.15	$1,737.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $575.44 / $691.83	Professional		$575.44	$575.44	$691.83
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $524.81 / $630.96 / $5,011.87	Facility		$524.81	$630.96	$5,011.87
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $602.56 / $602.56	Professional		$602.56	$602.56	$602.56
Cigna Facility/Professional Facility Modifier Low / Median / High Price $575.44 / $575.44 / $575.44	Facility		$575.44	$575.44	$575.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $575.44 / $575.44	Professional		$575.44	$575.44	$575.44
Geisinger Facility/Professional Facility Modifier Low / Median / High Price $575.44 / $575.44 / $575.44	Facility		$575.44	$575.44	$575.44
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $870.96 / $1,000.00 / $1,000.00	Professional		$870.96	$1,000.00	$1,000.00
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $575.44 / $1,096.48 / $1,737.80	Facility		$575.44	$1,096.48	$1,737.80
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $575.44 / $1,584.89	Professional		$575.44	$575.44	$1,584.89
United Facility/Professional Facility Modifier Low / Median / High Price $575.44 / $575.44 / $575.44	Facility		$575.44	$575.44	$575.44
United Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $575.44 / $1,000.00	Professional		$575.44	$575.44	$1,000.00