Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $758.58 / $758.58 / $1,288.25	Facility		$758.58	$758.58	$1,288.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $741.31 / $891.25	Professional		$724.44	$741.31	$891.25
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $1,412.54 / $1,659.59 / $5,011.87	Facility		$1,412.54	$1,659.59	$5,011.87
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $1,659.59 / $1,659.59 / $1,659.59	Professional		$1,659.59	$1,659.59	$1,659.59
Cigna Facility/Professional Facility Modifier Low / Median / High Price $758.58 / $758.58 / $758.58	Facility		$758.58	$758.58	$758.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $758.58 / $758.58	Professional		$758.58	$758.58	$758.58
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $933.25 / $933.25 / $1,000.00	Professional		$933.25	$933.25	$1,000.00
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $309.03 / $467.74	Professional		$309.03	$309.03	$467.74
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $758.58 / $758.58 / $1,288.25	Facility		$758.58	$758.58	$1,288.25
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $758.58 / $891.25	Professional		$724.44	$758.58	$891.25
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $0.60 / $691.83 / $794.33	Professional		$0.60	$691.83	$794.33
United Facility/Professional Professional Modifier Low / Median / High Price $1,698.24 / $1,995.26 / $2,187.76	Professional		$1,698.24	$1,995.26	$2,187.76