Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $145.49 / $336.73	Facility		$128.82	$145.49	$336.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $145.49 / $145.49 / $146.94	Professional		$145.49	$145.49	$146.94
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $124.20 / $145.49 / $8,639.91	Facility		$124.20	$145.49	$8,639.91
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $145.49 / $145.49 / $145.49	Professional		$145.49	$145.49	$145.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $145.49 / $145.49 / $145.49	Facility		$145.49	$145.49	$145.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $145.49 / $145.49 / $150.97	Professional		$145.49	$145.49	$150.97
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $123.67 / $145.49 / $185.84	Professional		$123.67	$145.49	$185.84
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $145.49 / $336.73	Facility		$128.82	$145.49	$336.73
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $145.49 / $145.49 / $146.94	Professional		$145.49	$145.49	$146.94
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $137.25 / $145.49 / $145.49	Facility		$137.25	$145.49	$145.49
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $145.49 / $145.49 / $164.70	Professional		$145.49	$145.49	$164.70
United Facility/Professional Professional Modifier Low / Median / High Price $145.49 / $145.49 / $200.92	Professional		$145.49	$145.49	$200.92