Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $127.50 / $191.25 / $328.95	Facility		$127.50	$191.25	$328.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $127.50 / $127.50 / $127.50	Professional		$127.50	$127.50	$127.50
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $105.83 / $124.50 / $8,639.91	Facility		$105.83	$124.50	$8,639.91
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $124.50 / $124.50 / $124.50	Professional		$124.50	$124.50	$124.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $127.50 / $127.50 / $127.50	Facility		$127.50	$127.50	$127.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $127.50 / $127.50 / $127.50	Professional		$127.50	$127.50	$127.50
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $127.50 / $191.25 / $328.95	Facility		$127.50	$191.25	$328.95
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $123.00 / $127.50 / $191.25	Professional		$123.00	$127.50	$191.25
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $127.50 / $127.50 / $127.50	Facility		$127.50	$127.50	$127.50
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $127.50 / $127.50 / $127.50	Professional		$127.50	$127.50	$127.50
United Facility/Professional Professional Modifier Low / Median / High Price $125.00 / $125.00 / $228.75	Professional		$125.00	$125.00	$228.75