Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $741.62 / $1,702.15 / $2,085.67	Facility		$741.62	$1,702.15	$2,085.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $741.62 / $875.57 / $1,112.45	Professional		$741.62	$875.57	$1,112.45
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $1,024.18 / $1,199.70 / $8,459.92	Facility		$1,024.18	$1,199.70	$8,459.92
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $1,199.70 / $1,199.70 / $1,199.70	Professional		$1,199.70	$1,199.70	$1,199.70
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,001.02 / $1,001.02 / $1,001.02	Facility		$1,001.02	$1,001.02	$1,001.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,112.45 / $1,308.77 / $2,329.63	Professional		$1,112.45	$1,308.77	$2,329.63
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $1,112.45 / $1,112.45 / $1,112.45	Professional		$1,112.45	$1,112.45	$1,112.45
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $741.62 / $1,253.33 / $2,121.27	Facility		$741.62	$1,253.33	$2,121.27
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $741.62 / $875.57 / $1,253.33	Professional		$741.62	$875.57	$1,253.33
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $1,849.70 / $2,034.70 / $2,242.80	Professional		$1,849.70	$2,034.70	$2,242.80
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $1,001.02 / $1,001.02 / $1,001.02	Facility		$1,001.02	$1,001.02	$1,001.02
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $1,112.45 / $1,271.59 / $1,523.52	Professional		$1,112.45	$1,271.59	$1,523.52
United Facility/Professional Professional Modifier Low / Median / High Price $1,177.89 / $1,308.77 / $1,635.96	Professional		$1,177.89	$1,308.77	$1,635.96