Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $251.19 / $389.05	Facility		$138.04	$251.19	$389.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $138.04 / $162.18	Professional		$128.82	$138.04	$162.18
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $234.42 / $275.42 / $5,011.87	Facility		$234.42	$275.42	$5,011.87
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $275.42 / $275.42	Professional		$275.42	$275.42	$275.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $138.04 / $138.04	Facility		$138.04	$138.04	$138.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $138.04 / $138.04	Professional		$138.04	$138.04	$138.04
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $134.90 / $134.90	Professional		$134.90	$134.90	$134.90
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $218.78 / $354.81	Facility		$138.04	$218.78	$354.81
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $138.04 / $331.13	Professional		$128.82	$138.04	$331.13
United Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $331.13 / $457.09	Professional		$331.13	$331.13	$457.09