Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,096.85 / $6,145.28 / $10,160.20	Facility		$4,096.85	$6,145.28	$10,160.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $3,855.86 / $4,096.85 / $4,096.85	Professional		$3,855.86	$4,096.85	$4,096.85
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $4,027.52 / $4,717.72 / $8,639.91	Facility		$4,027.52	$4,717.72	$8,639.91
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $4,717.72 / $4,717.72 / $4,717.72	Professional		$4,717.72	$4,717.72	$4,717.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,819.82 / $4,819.82 / $4,819.82	Facility		$4,819.82	$4,819.82	$4,819.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $4,819.82 / $4,819.82 / $5,001.70	Professional		$4,819.82	$4,819.82	$5,001.70
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $4,831.39 / $4,831.39 / $5,684.00	Professional		$4,831.39	$4,831.39	$5,684.00
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $4,096.85 / $6,063.34 / $10,160.20	Facility		$4,096.85	$6,063.34	$10,160.20
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $3,855.86 / $4,096.85 / $6,391.09	Professional		$3,855.86	$4,096.85	$6,391.09
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $7,711.70 / $8,482.90 / $9,350.50	Professional		$7,711.70	$8,482.90	$9,350.50
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $4,819.82 / $4,819.82 / $4,819.82	Facility		$4,819.82	$4,819.82	$4,819.82
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $4,819.82 / $4,819.82 / $5,229.05	Professional		$4,819.82	$4,819.82	$5,229.05
United Facility/Professional Professional Modifier Low / Median / High Price $5,399.80 / $6,025.04 / $7,673.40	Professional		$5,399.80	$6,025.04	$7,673.40