Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $8,628.84 / $12,408.10 / $21,399.50	Facility		$8,628.84	$12,408.10	$21,399.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $8,121.26 / $8,628.84 / $8,628.84	Professional		$8,121.26	$8,628.84	$8,628.84
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $4,795.41 / $5,617.21 / $8,639.91	Facility		$4,795.41	$5,617.21	$8,639.91
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $4,342.71 / $4,342.71 / $4,342.71	Professional		$4,342.71	$4,342.71	$4,342.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $8,628.84 / $8,628.84 / $8,628.84	Facility		$8,628.84	$8,628.84	$8,628.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $8,628.84 / $8,628.84 / $8,628.84	Professional		$8,628.84	$8,628.84	$8,628.84
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $8,628.84 / $8,628.84 / $8,628.84	Professional		$8,628.84	$8,628.84	$8,628.84
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $8,628.84 / $12,511.80 / $21,399.50	Facility		$8,628.84	$12,511.80	$21,399.50
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $8,121.26 / $8,628.84 / $13,461.00	Professional		$8,121.26	$8,628.84	$13,461.00
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 $8,628.84 / $8,628.84 / $8,628.84	Facility		$8,628.84	$8,628.84	$8,628.84
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $8,628.84 / $8,628.84 / $8,628.84	Professional		$8,628.84	$8,628.84	$8,628.84
United Facility/Professional Professional Modifier Low / Median / High Price $8,459.66 / $8,967.24 / $12,252.13	Professional		$8,459.66	$8,967.24	$12,252.13