Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $89.31 / $130.38 / $221.49	Facility		$89.31	$130.38	$221.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $84.06 / $89.31 / $89.31	Professional		$84.06	$89.31	$89.31
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $74.45 / $87.21 / $8,459.92	Facility		$74.45	$87.21	$8,459.92
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $87.21 / $87.21 / $87.21	Professional		$87.21	$87.21	$87.21
Cigna Facility/Professional Facility Modifier Low / Median / High Price $89.31 / $89.31 / $89.31	Facility		$89.31	$89.31	$89.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.31 / $89.31 / $89.31	Professional		$89.31	$89.31	$89.31
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $89.31 / $89.31 / $89.31	Professional		$89.31	$89.31	$89.31
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $89.31 / $130.38 / $221.49	Facility		$89.31	$130.38	$221.49
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $84.06 / $89.31 / $150.93	Professional		$84.06	$89.31	$150.93
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $27.40 / $27.40 / $27.40	Professional		$27.40	$27.40	$27.40
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $89.31 / $89.31 / $89.31	Facility		$89.31	$89.31	$89.31
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $89.31 / $89.31 / $89.31	Professional		$89.31	$89.31	$89.31
United Facility/Professional Professional Modifier Low / Median / High Price $87.56 / $92.81 / $116.96	Professional		$87.56	$92.81	$116.96