Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,269.90 / $1,269.90 / $1,269.90	Facility		$1,269.90	$1,269.90	$1,269.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,195.20 / $1,269.90 / $1,269.90	Professional		$1,195.20	$1,269.90	$1,269.90
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $658.97 / $771.90 / $8,639.91	Facility		$658.97	$771.90	$8,639.91
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $771.90 / $771.90 / $771.90	Professional		$771.90	$771.90	$771.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,269.90 / $1,269.90 / $1,269.90	Facility		$1,269.90	$1,269.90	$1,269.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,269.90 / $1,269.90 / $1,269.90	Professional		$1,269.90	$1,269.90	$1,269.90
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $302.26 / $1,157.45 / $1,361.70	Professional		$302.26	$1,157.45	$1,361.70
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $1,269.90 / $1,269.90 / $1,269.90	Facility		$1,269.90	$1,269.90	$1,269.90
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $1,195.20 / $1,269.90 / $1,269.90	Professional		$1,195.20	$1,269.90	$1,269.90
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $1,269.90 / $1,269.90 / $1,269.90	Facility		$1,269.90	$1,269.90	$1,269.90
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $1,269.90 / $1,269.90 / $1,269.90	Professional		$1,269.90	$1,269.90	$1,269.90
United Facility/Professional Professional Modifier Low / Median / High Price $1,245.00 / $1,245.00 / $1,556.25	Professional		$1,245.00	$1,245.00	$1,556.25