Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $147.90 / $147.90 / $147.90	Facility		$147.90	$147.90	$147.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $139.19 / $147.90 / $147.90	Professional		$139.19	$147.90	$147.90
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $123.29 / $144.41 / $8,639.91	Facility		$123.29	$144.41	$8,639.91
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $144.41 / $144.41 / $144.41	Professional		$144.41	$144.41	$144.41
Cigna Facility/Professional Facility Modifier Low / Median / High Price $147.90 / $147.90 / $147.90	Facility		$147.90	$147.90	$147.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $147.90 / $147.90 / $147.90	Professional		$147.90	$147.90	$147.90
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $147.90 / $147.90 / $147.90	Professional		$147.90	$147.90	$147.90
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $147.90 / $147.90 / $249.95	Facility		$147.90	$147.90	$249.95
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $139.19 / $147.90 / $176.00	Professional		$139.19	$147.90	$176.00
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $147.90 / $147.90 / $147.90	Facility		$147.90	$147.90	$147.90
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $147.90 / $147.90 / $147.90	Professional		$147.90	$147.90	$147.90
United Facility/Professional Professional Modifier Low / Median / High Price $145.00 / $145.00 / $181.25	Professional		$145.00	$145.00	$181.25