Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $85.96 / $85.96 / $85.96	Facility		$85.96	$85.96	$85.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $80.90 / $85.96 / $85.96	Professional		$80.90	$85.96	$85.96
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $109.83 / $128.65 / $8,639.91	Facility		$109.83	$128.65	$8,639.91
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $128.65 / $128.65 / $128.65	Professional		$128.65	$128.65	$128.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $85.96 / $85.96 / $85.96	Facility		$85.96	$85.96	$85.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.96 / $85.96 / $85.96	Professional		$85.96	$85.96	$85.96
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $96.09 / $100.45 / $125.37	Professional		$96.09	$100.45	$125.37
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $85.96 / $85.96 / $145.27	Facility		$85.96	$85.96	$145.27
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $80.90 / $85.96 / $102.29	Professional		$80.90	$85.96	$102.29
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $158.69 / $182.50 / $194.40	Professional		$158.69	$182.50	$194.40
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $85.96 / $85.96 / $85.96	Facility		$85.96	$85.96	$85.96
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $85.96 / $85.96 / $85.96	Professional		$85.96	$85.96	$85.96
United Facility/Professional Professional Modifier Low / Median / High Price $136.47 / $136.47 / $178.09	Professional		$136.47	$136.47	$178.09