Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $655.29 / $661.85 / $1,928.34	Facility		$655.29	$661.85	$1,928.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $655.29 / $655.29 / $661.85	Professional		$655.29	$655.29	$661.85
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $559.42 / $655.29 / $8,639.91	Facility		$559.42	$655.29	$8,639.91
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $655.29 / $655.29 / $655.29	Professional		$655.29	$655.29	$655.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $655.29 / $655.29 / $655.29	Facility		$655.29	$655.29	$655.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $655.29 / $655.29 / $680.03	Professional		$655.29	$655.29	$680.03
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $557.01 / $655.29 / $837.06	Professional		$557.01	$655.29	$837.06
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $655.29 / $737.74 / $1,928.34	Facility		$655.29	$737.74	$1,928.34
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $655.29 / $655.29 / $737.74	Professional		$655.29	$655.29	$737.74
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $618.21 / $655.29 / $655.29	Facility		$618.21	$655.29	$655.29
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $655.29 / $655.29 / $834.58	Professional		$655.29	$655.29	$834.58
United Facility/Professional Professional Modifier Low / Median / High Price $655.29 / $655.29 / $979.94	Professional		$655.29	$655.29	$979.94