Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $489.26 / $489.26 / $826.85	Facility		$489.26	$489.26	$826.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $460.48 / $489.26 / $489.26	Professional		$460.48	$489.26	$489.26
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $407.86 / $477.75 / $8,459.92	Facility		$407.86	$477.75	$8,459.92
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $477.75 / $477.75 / $477.75	Professional		$477.75	$477.75	$477.75
Cigna Facility/Professional Facility Modifier Low / Median / High Price $508.43 / $508.43 / $508.43	Facility		$508.43	$508.43	$508.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $508.43 / $508.43 / $527.62	Professional		$508.43	$508.43	$527.62
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $494.20 / $494.20 / $636.02	Professional		$494.20	$494.20	$636.02
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $489.26 / $489.26 / $826.85	Facility		$489.26	$489.26	$826.85
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $460.48 / $489.26 / $582.22	Professional		$460.48	$489.26	$582.22
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $27.40 / $797.20 / $966.60	Professional		$27.40	$797.20	$966.60
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $508.43 / $508.43 / $508.43	Facility		$508.43	$508.43	$508.43
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $508.43 / $508.43 / $551.60	Professional		$508.43	$508.43	$551.60
United Facility/Professional Professional Modifier Low / Median / High Price $575.60 / $610.14 / $777.06	Professional		$575.60	$610.14	$777.06