Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,393.12 / $1,407.05 / $4,522.80	Facility		$1,393.12	$1,407.05	$4,522.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,393.12 / $1,393.12 / $1,407.05	Professional		$1,393.12	$1,393.12	$1,407.05
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $1,184.15 / $1,393.12 / $2,089.67	Facility		$1,184.15	$1,393.12	$2,089.67
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $1,393.12 / $1,393.12 / $1,393.12	Professional		$1,393.12	$1,393.12	$1,393.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,393.12 / $1,393.12 / $1,393.12	Facility		$1,393.12	$1,393.12	$1,393.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,393.12 / $1,393.12 / $1,445.69	Professional		$1,393.12	$1,393.12	$1,445.69
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $1,184.15 / $1,393.12 / $1,779.51	Professional		$1,184.15	$1,393.12	$1,779.51
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $1,393.12 / $1,730.31 / $4,522.80	Facility		$1,393.12	$1,730.31	$4,522.80
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $1,393.12 / $1,393.12 / $1,730.31	Professional		$1,393.12	$1,393.12	$1,730.31
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $1,314.26 / $1,393.12 / $1,393.12	Facility		$1,314.26	$1,393.12	$1,393.12
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $1,393.12 / $1,393.12 / $1,774.26	Professional		$1,393.12	$1,393.12	$1,774.26
United Facility/Professional Professional Modifier Low / Median / High Price $1,393.12 / $1,393.12 / $1,989.86	Professional		$1,393.12	$1,393.12	$1,989.86