Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,971.34 / $6,910.16 / $12,328.90	Facility		$4,971.34	$6,910.16	$12,328.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $4,678.89 / $4,971.34 / $5,374.02	Professional		$4,678.89	$4,971.34	$5,374.02
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $4,144.17 / $4,854.35 / $8,639.91	Facility		$4,144.17	$4,854.35	$8,639.91
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $4,854.35 / $4,854.35 / $4,854.35	Professional		$4,854.35	$4,854.35	$4,854.35
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,971.34 / $4,971.34 / $4,971.34	Facility		$4,971.34	$4,971.34	$4,971.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $4,971.34 / $4,971.34 / $4,971.34	Professional		$4,971.34	$4,971.34	$4,971.34
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $5,361.25 / $5,848.63 / $6,462.74	Professional		$5,361.25	$5,848.63	$6,462.74
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $4,971.34 / $7,258.16 / $12,328.90	Facility		$4,971.34	$7,258.16	$12,328.90
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $4,678.89 / $4,971.34 / $11,942.30	Professional		$4,678.89	$4,971.34	$11,942.30
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $4,769.70 / $5,783.20 / $11,624.20	Professional		$4,769.70	$5,783.20	$11,624.20
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $4,971.34 / $4,971.34 / $4,971.34	Facility		$4,971.34	$4,971.34	$4,971.34
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $4,971.34 / $4,971.34 / $4,971.34	Professional		$4,971.34	$4,971.34	$4,971.34
United Facility/Professional Professional Modifier Low / Median / High Price $4,873.85 / $5,166.29 / $7,067.10	Professional		$4,873.85	$5,166.29	$7,067.10