Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $915.68 / $915.68 / $915.68	Facility		$915.68	$915.68	$915.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $869.90 / $915.68 / $950.57	Professional		$869.90	$915.68	$950.57
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $772.59 / $904.99 / $8,639.91	Facility		$772.59	$904.99	$8,639.91
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $904.99 / $904.99 / $904.99	Professional		$904.99	$904.99	$904.99
Cigna Facility/Professional Facility Modifier Low / Median / High Price $872.08 / $872.08 / $872.08	Facility		$872.08	$872.08	$872.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $872.08 / $872.08 / $872.08	Professional		$872.08	$872.08	$872.08
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $904.99 / $946.12 / $1,180.80	Professional		$904.99	$946.12	$1,180.80
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $915.68 / $915.68 / $1,547.50	Facility		$915.68	$915.68	$1,547.50
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $872.08 / $915.68 / $1,089.66	Professional		$872.08	$915.68	$1,089.66
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $631.40 / $663.00 / $765.60	Professional		$631.40	$663.00	$765.60
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $872.08 / $872.08 / $872.08	Facility		$872.08	$872.08	$872.08
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $872.08 / $872.08 / $876.09	Professional		$872.08	$872.08	$876.09
United Facility/Professional Professional Modifier Low / Median / High Price $872.08 / $872.08 / $1,204.33	Professional		$872.08	$872.08	$1,204.33