Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $408.00 / $408.00 / $408.00	Facility		$408.00	$408.00	$408.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $384.00 / $408.00 / $408.00	Professional		$384.00	$408.00	$408.00
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $340.34 / $398.66 / $8,639.91	Facility		$340.34	$398.66	$8,639.91
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $398.66 / $398.66 / $398.66	Professional		$398.66	$398.66	$398.66
Cigna Facility/Professional Facility Modifier Low / Median / High Price $408.00 / $408.00 / $408.00	Facility		$408.00	$408.00	$408.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $408.00 / $408.00 / $408.00	Professional		$408.00	$408.00	$408.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $289.00 / $340.00 / $340.00	Professional		$289.00	$340.00	$340.00
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $408.00 / $408.00 / $408.00	Facility		$408.00	$408.00	$408.00
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $384.00 / $408.00 / $408.00	Professional		$384.00	$408.00	$408.00
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $408.00 / $408.00 / $408.00	Facility		$408.00	$408.00	$408.00
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $408.00 / $408.00 / $408.00	Professional		$408.00	$408.00	$408.00
United Facility/Professional Professional Modifier Low / Median / High Price $456.00 / $480.00 / $626.40	Professional		$456.00	$480.00	$626.40