Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $88.43 / $141.49 / $219.31	Facility		$88.43	$141.49	$219.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $88.43 / $88.43 / $88.43	Professional		$88.43	$88.43	$88.43
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $73.40 / $86.35 / $8,639.91	Facility		$73.40	$86.35	$8,639.91
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $86.35 / $86.35 / $86.35	Professional		$86.35	$86.35	$86.35
Cigna Facility/Professional Facility Modifier Low / Median / High Price $88.43 / $88.43 / $88.43	Facility		$88.43	$88.43	$88.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $88.43 / $88.43 / $88.43	Professional		$88.43	$88.43	$88.43
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $88.43 / $136.18 / $219.31	Facility		$88.43	$136.18	$219.31
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $88.43 / $88.43 / $175.98	Professional		$88.43	$88.43	$175.98
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $88.43 / $88.43 / $88.43	Facility		$88.43	$88.43	$88.43
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $88.43 / $88.43 / $88.43	Professional		$88.43	$88.43	$88.43
United Facility/Professional Professional Modifier Low / Median / High Price $86.70 / $86.70 / $113.14	Professional		$86.70	$86.70	$113.14