Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $162.18 / $245.47	Facility		$89.13	$162.18	$245.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $87.10 / $104.71	Professional		$83.18	$87.10	$104.71
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $87.10 / $5,011.87	Facility		$74.13	$87.10	$5,011.87
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $87.10 / $87.10	Professional		$87.10	$87.10	$87.10
Cigna Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $89.13 / $89.13	Facility		$89.13	$89.13	$89.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $89.13 / $89.13	Professional		$89.13	$89.13	$89.13
Geisinger Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $89.13 / $89.13	Facility		$89.13	$89.13	$89.13
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $141.25 / $229.09	Facility		$89.13	$141.25	$229.09
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $87.10 / $177.83	Professional		$83.18	$87.10	$177.83
United Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $87.10 / $120.23	Professional		$87.10	$87.10	$120.23