Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $89.41 / $90.30 / $245.81	Facility		$89.41	$90.30	$245.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.41 / $89.41 / $90.30	Professional		$89.41	$89.41	$90.30
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $76.33 / $89.41 / $8,639.91	Facility		$76.33	$89.41	$8,639.91
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $89.41 / $89.41 / $89.41	Professional		$89.41	$89.41	$89.41
Cigna Facility/Professional Facility Modifier Low / Median / High Price $89.41 / $89.41 / $89.41	Facility		$89.41	$89.41	$89.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.41 / $89.41 / $97.00	Professional		$89.41	$89.41	$97.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $88.57 / $92.79 / $114.21	Professional		$88.57	$92.79	$114.21
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $89.41 / $94.04 / $245.81	Facility		$89.41	$94.04	$245.81
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $89.41 / $89.41 / $94.04	Professional		$89.41	$89.41	$94.04
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $84.35 / $89.41 / $89.41	Facility		$84.35	$89.41	$89.41
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $89.41 / $89.41 / $104.10	Professional		$89.41	$89.41	$104.10
United Facility/Professional Professional Modifier Low / Median / High Price $89.41 / $89.41 / $149.47	Professional		$89.41	$89.41	$149.47