Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,870.00 / $1,870.00 / $1,870.00	Facility		$1,870.00	$1,870.00	$1,870.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,760.00 / $1,870.00 / $1,870.00	Professional		$1,760.00	$1,870.00	$1,870.00
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $1,552.10 / $1,826.00 / $8,639.91	Facility		$1,552.10	$1,826.00	$8,639.91
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $1,826.00 / $1,826.00 / $1,826.00	Professional		$1,826.00	$1,826.00	$1,826.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,870.00 / $1,870.00 / $1,870.00	Facility		$1,870.00	$1,870.00	$1,870.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,870.00 / $1,870.00 / $1,870.00	Professional		$1,870.00	$1,870.00	$1,870.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $1,870.00 / $1,870.00 / $1,870.00	Professional		$1,870.00	$1,870.00	$1,870.00
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $1,870.00 / $1,870.00 / $1,870.00	Facility		$1,870.00	$1,870.00	$1,870.00
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $1,760.00 / $1,870.00 / $1,870.00	Professional		$1,760.00	$1,870.00	$1,870.00
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $1,870.00 / $1,870.00 / $1,870.00	Facility		$1,870.00	$1,870.00	$1,870.00
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $1,870.00 / $1,870.00 / $1,870.00	Professional		$1,870.00	$1,870.00	$1,870.00
United Facility/Professional Professional Modifier Low / Median / High Price $2,181.67 / $2,200.00 / $2,871.00	Professional		$2,181.67	$2,200.00	$2,871.00