Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $61.52 / $116.29 / $152.57	Facility		$61.52	$116.29	$152.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.90 / $61.52 / $61.52	Professional		$57.90	$61.52	$61.52
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $101.87 / $119.33 / $8,459.92	Facility		$101.87	$119.33	$8,459.92
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $119.33 / $119.33 / $119.33	Professional		$119.33	$119.33	$119.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $61.52 / $61.52 / $61.52	Facility		$61.52	$61.52	$61.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.52 / $61.52 / $61.52	Professional		$61.52	$61.52	$61.52
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $60.31 / $60.31 / $126.65	Professional		$60.31	$60.31	$126.65
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $61.52 / $92.28 / $158.72	Facility		$61.52	$92.28	$158.72
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $57.90 / $61.52 / $103.97	Professional		$57.90	$61.52	$103.97
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $107.20 / $117.90 / $130.00	Professional		$107.20	$117.90	$130.00
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $61.52 / $61.52 / $61.52	Facility		$61.52	$61.52	$61.52
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $61.52 / $61.52 / $61.52	Professional		$61.52	$61.52	$61.52
United Facility/Professional Professional Modifier Low / Median / High Price $60.32 / $60.32 / $75.40	Professional		$60.32	$60.32	$75.40