Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,452.25 / $1,466.78 / $4,554.10	Facility		$1,452.25	$1,466.78	$4,554.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,452.25 / $1,452.25 / $1,466.78	Professional		$1,452.25	$1,452.25	$1,466.78
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $1,234.41 / $1,452.25 / $8,639.91	Facility		$1,234.41	$1,452.25	$8,639.91
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $1,452.25 / $1,452.25 / $1,452.25	Professional		$1,452.25	$1,452.25	$1,452.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,452.25 / $1,452.25 / $1,452.25	Facility		$1,452.25	$1,452.25	$1,452.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,452.25 / $1,452.25 / $1,507.05	Professional		$1,452.25	$1,452.25	$1,507.05
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $1,234.41 / $1,452.25 / $1,855.05	Professional		$1,234.41	$1,452.25	$1,855.05
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $1,452.25 / $1,742.29 / $4,554.10	Facility		$1,452.25	$1,742.29	$4,554.10
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $1,452.25 / $1,452.25 / $1,742.29	Professional		$1,452.25	$1,452.25	$1,742.29
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $1,370.05 / $1,452.25 / $1,452.25	Facility		$1,370.05	$1,452.25	$1,452.25
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $1,452.25 / $1,452.25 / $1,849.57	Professional		$1,452.25	$1,452.25	$1,849.57
United Facility/Professional Professional Modifier Low / Median / High Price $1,452.25 / $1,452.25 / $2,178.38	Professional		$1,452.25	$1,452.25	$2,178.38