Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $411.15 / $608.50 / $1,019.65	Facility		$411.15	$608.50	$1,019.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $386.96 / $411.15 / $444.45	Professional		$386.96	$411.15	$444.45
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $342.73 / $401.47 / $8,459.92	Facility		$342.73	$401.47	$8,459.92
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $401.47 / $401.47 / $401.47	Professional		$401.47	$401.47	$401.47
Cigna Facility/Professional Facility Modifier Low / Median / High Price $411.15 / $411.15 / $411.15	Facility		$411.15	$411.15	$411.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $411.15 / $411.15 / $411.15	Professional		$411.15	$411.15	$411.15
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $411.15 / $411.15 / $534.48	Professional		$411.15	$411.15	$534.48
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $411.15 / $600.28 / $1,019.65	Facility		$411.15	$600.28	$1,019.65
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $386.96 / $411.15 / $1,011.43	Professional		$386.96	$411.15	$1,011.43
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $27.40 / $588.40 / $961.40	Professional		$27.40	$588.40	$961.40
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $411.15 / $411.15 / $411.15	Facility		$411.15	$411.15	$411.15
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $411.15 / $411.15 / $411.15	Professional		$411.15	$411.15	$411.15
United Facility/Professional Professional Modifier Low / Median / High Price $403.08 / $427.26 / $556.65	Professional		$403.08	$427.26	$556.65