Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $762.88 / $762.88 / $762.88	Facility		$762.88	$762.88	$762.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $718.00 / $762.88 / $762.88	Professional		$718.00	$762.88	$762.88
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $1,409.23 / $1,657.92 / $8,639.91	Facility		$1,409.23	$1,657.92	$8,639.91
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $1,657.92 / $1,657.92 / $1,657.92	Professional		$1,657.92	$1,657.92	$1,657.92
Cigna Facility/Professional Facility Modifier Low / Median / High Price $762.88 / $762.88 / $762.88	Facility		$762.88	$762.88	$762.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $762.88 / $762.88 / $762.88	Professional		$762.88	$762.88	$762.88
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $935.00 / $935.00 / $1,245.07	Professional		$935.00	$935.00	$1,245.07
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $762.88 / $762.88 / $1,289.27	Facility		$762.88	$762.88	$1,289.27
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $718.00 / $762.88 / $907.83	Professional		$718.00	$762.88	$907.83
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 $762.88 / $762.88 / $762.88	Facility		$762.88	$762.88	$762.88
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $762.88 / $762.88 / $762.88	Professional		$762.88	$762.88	$762.88
United Facility/Professional Professional Modifier Low / Median / High Price $1,997.50 / $1,997.50 / $2,758.55	Professional		$1,997.50	$1,997.50	$2,758.55