Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $604.66 / $906.99 / $1,499.56	Facility		$604.66	$906.99	$1,499.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $569.09 / $604.66 / $604.66	Professional		$569.09	$604.66	$604.66
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $556.67 / $652.08 / $8,459.92	Facility		$556.67	$652.08	$8,459.92
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $652.08 / $652.08 / $652.08	Professional		$652.08	$652.08	$652.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $628.37 / $628.37 / $628.37	Facility		$628.37	$628.37	$628.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $628.37 / $628.37 / $652.08	Professional		$628.37	$628.37	$652.08
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $663.32 / $663.32 / $802.69	Professional		$663.32	$663.32	$802.69
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $604.66 / $906.99 / $1,499.56	Facility		$604.66	$906.99	$1,499.56
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $569.09 / $604.66 / $906.99	Professional		$569.09	$604.66	$906.99
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $27.40 / $851.30 / $1,025.80	Professional		$27.40	$851.30	$1,025.80
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $628.37 / $628.37 / $628.37	Facility		$628.37	$628.37	$628.37
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $628.37 / $628.37 / $681.72	Professional		$628.37	$628.37	$681.72
United Facility/Professional Professional Modifier Low / Median / High Price $592.79 / $628.37 / $805.01	Professional		$592.79	$628.37	$805.01