Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $53.95 / $80.93 / $133.80	Facility		$53.95	$80.93	$133.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.95 / $53.95 / $53.95	Professional		$53.95	$53.95	$53.95
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $42.22 / $49.67 / $8,639.91	Facility		$42.22	$49.67	$8,639.91
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $49.67 / $49.67 / $49.67	Professional		$49.67	$49.67	$49.67
Cigna Facility/Professional Facility Modifier Low / Median / High Price $53.95 / $53.95 / $53.95	Facility		$53.95	$53.95	$53.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $53.95 / $53.95 / $53.95	Professional		$53.95	$53.95	$53.95
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $53.95 / $80.93 / $139.19	Facility		$53.95	$80.93	$139.19
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $52.05 / $53.95 / $139.19	Professional		$52.05	$53.95	$139.19
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $53.95 / $53.95 / $53.95	Facility		$53.95	$53.95	$53.95
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $53.95 / $53.95 / $53.95	Professional		$53.95	$53.95	$53.95
United Facility/Professional Professional Modifier Low / Median / High Price $52.89 / $52.89 / $73.04	Professional		$52.89	$52.89	$73.04