Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $102.80 / $102.80 / $102.80	Facility		$102.80	$102.80	$102.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $96.75 / $102.80 / $102.80	Professional		$96.75	$102.80	$102.80
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $85.75 / $100.45 / $8,639.91	Facility		$85.75	$100.45	$8,639.91
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $100.45 / $100.45 / $100.45	Professional		$100.45	$100.45	$100.45
Cigna Facility/Professional Facility Modifier Low / Median / High Price $102.80 / $102.80 / $102.80	Facility		$102.80	$102.80	$102.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.80 / $102.80 / $102.80	Professional		$102.80	$102.80	$102.80
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $87.38 / $102.80 / $102.80	Professional		$87.38	$102.80	$102.80
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $102.80 / $102.80 / $102.80	Facility		$102.80	$102.80	$102.80
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $96.75 / $102.80 / $102.80	Professional		$96.75	$102.80	$102.80
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $102.80 / $102.80 / $102.80	Facility		$102.80	$102.80	$102.80
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $102.80 / $102.80 / $102.80	Professional		$102.80	$102.80	$102.80
United Facility/Professional Professional Modifier Low / Median / High Price $100.78 / $100.78 / $131.52	Professional		$100.78	$100.78	$131.52