Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $143.31 / $229.30 / $355.41	Facility		$143.31	$229.30	$355.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $143.31 / $143.31 / $143.31	Professional		$143.31	$143.31	$143.31
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $82.54 / $97.11 / $8,639.91	Facility		$82.54	$97.11	$8,639.91
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $97.11 / $97.11 / $97.11	Professional		$97.11	$97.11	$97.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $143.31 / $143.31 / $143.31	Facility		$143.31	$143.31	$143.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $143.31 / $143.31 / $143.31	Professional		$143.31	$143.31	$143.31
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $143.31 / $214.97 / $355.41	Facility		$143.31	$214.97	$355.41
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $138.25 / $143.31 / $214.97	Professional		$138.25	$143.31	$214.97
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $143.31 / $143.31 / $143.31	Facility		$143.31	$143.31	$143.31
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $143.31 / $143.31 / $143.31	Professional		$143.31	$143.31	$143.31
United Facility/Professional Professional Modifier Low / Median / High Price $140.50 / $140.50 / $194.03	Professional		$140.50	$140.50	$194.03