Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $43.30 / $86.22 / $168.37	Facility		$43.30	$86.22	$168.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.89 / $67.89 / $67.89	Professional		$67.89	$67.89	$67.89
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $56.36 / $66.30 / $8,639.91	Facility		$56.36	$66.30	$8,639.91
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $66.30 / $66.30 / $66.30	Professional		$66.30	$66.30	$66.30
Cigna Facility/Professional Facility Modifier Low / Median / High Price $67.89 / $67.89 / $67.89	Facility		$67.89	$67.89	$67.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.89 / $67.89 / $67.89	Professional		$67.89	$67.89	$67.89
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $67.89 / $101.84 / $168.37	Facility		$67.89	$101.84	$168.37
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $67.89 / $67.89 / $135.10	Professional		$67.89	$67.89	$135.10
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $67.89 / $67.89 / $67.89	Facility		$67.89	$67.89	$67.89
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $67.89 / $67.89 / $67.89	Professional		$67.89	$67.89	$67.89
United Facility/Professional Professional Modifier Low / Median / High Price $66.56 / $66.56 / $86.86	Professional		$66.56	$66.56	$86.86