Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,640.93 / $1,657.34 / $4,332.06	Facility		$1,640.93	$1,657.34	$4,332.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,640.93 / $1,640.93 / $1,657.34	Professional		$1,640.93	$1,640.93	$1,657.34
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $1,394.79 / $1,640.93 / $8,639.91	Facility		$1,394.79	$1,640.93	$8,639.91
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $1,640.93 / $1,640.93 / $1,640.93	Professional		$1,640.93	$1,640.93	$1,640.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,571.96 / $1,640.93 / $1,640.93	Facility		$1,571.96	$1,640.93	$1,640.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,640.93 / $1,640.93 / $1,640.93	Professional		$1,640.93	$1,640.93	$1,640.93
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $1,625.45 / $1,702.86 / $2,096.06	Professional		$1,625.45	$1,702.86	$2,096.06
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $1,640.93 / $1,657.34 / $4,332.06	Facility		$1,640.93	$1,657.34	$4,332.06
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $1,640.93 / $1,640.93 / $1,657.34	Professional		$1,640.93	$1,640.93	$1,657.34
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $1,548.05 / $1,640.93 / $1,640.93	Facility		$1,548.05	$1,640.93	$1,640.93
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $1,640.93 / $1,640.93 / $1,640.93	Professional		$1,640.93	$1,640.93	$1,640.93
United Facility/Professional Professional Modifier Low / Median / High Price $1,558.88 / $1,640.93 / $2,051.16	Professional		$1,558.88	$1,640.93	$2,051.16