Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $446.68 / $457.09 / $457.09	Facility		$446.68	$457.09	$457.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $446.68 / $831.76	Professional		$446.68	$446.68	$831.76
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $1,096.48 / $1,288.25 / $1,621.81	Facility		$1,096.48	$1,288.25	$1,621.81
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $1,288.25 / $1,288.25 / $1,288.25	Professional		$1,288.25	$1,288.25	$1,288.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $446.68 / $446.68 / $446.68	Facility		$446.68	$446.68	$446.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $446.68 / $489.78	Professional		$446.68	$446.68	$489.78
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $1,122.02 / $1,318.26	Professional		$154.88	$1,122.02	$1,318.26
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $162.18 / $223.87	Professional		$120.23	$162.18	$223.87
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $446.68 / $457.09 / $457.09	Facility		$446.68	$457.09	$457.09
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $446.68 / $575.44	Professional		$446.68	$446.68	$575.44
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $0.60 / $229.09 / $245.47	Professional		$0.60	$229.09	$245.47
United Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $478.63 / $1,318.26	Professional		$125.89	$478.63	$1,318.26