Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $424.47 / $424.47 / $424.47	Facility		$424.47	$424.47	$424.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $399.50 / $424.47 / $424.47	Professional		$399.50	$424.47	$424.47
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $353.85 / $414.49 / $8,639.91	Facility		$353.85	$414.49	$8,639.91
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $414.49 / $414.49 / $414.49	Professional		$414.49	$414.49	$414.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $424.47 / $424.47 / $424.47	Facility		$424.47	$424.47	$424.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $424.47 / $424.47 / $424.47	Professional		$424.47	$424.47	$424.47
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $360.80 / $424.47 / $424.47	Professional		$360.80	$424.47	$424.47
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $424.47 / $424.47 / $424.47	Facility		$424.47	$424.47	$424.47
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $399.50 / $424.47 / $424.47	Professional		$399.50	$424.47	$424.47
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $424.47 / $424.47 / $424.47	Facility		$424.47	$424.47	$424.47
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $424.47 / $424.47 / $424.47	Professional		$424.47	$424.47	$424.47
United Facility/Professional Professional Modifier Low / Median / High Price $474.45 / $499.42 / $689.70	Professional		$474.45	$499.42	$689.70