Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $371.54 / $371.54 / $389.05	Facility		$371.54	$371.54	$389.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $354.81 / $389.05	Professional		$114.82	$354.81	$389.05
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $338.84 / $398.11 / $5,011.87	Facility		$338.84	$398.11	$5,011.87
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $398.11 / $398.11	Professional		$398.11	$398.11	$398.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $407.38 / $407.38 / $407.38	Facility		$407.38	$407.38	$407.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $407.38 / $407.38	Professional		$407.38	$407.38	$407.38
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $407.38 / $407.38	Professional		$162.18	$407.38	$407.38
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $158.49 / $208.93	Professional		$120.23	$158.49	$208.93
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $371.54 / $371.54 / $389.05	Facility		$371.54	$371.54	$389.05
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $354.81 / $389.05	Professional		$114.82	$354.81	$389.05
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $0.60 / $194.98 / $245.47	Professional		$0.60	$194.98	$245.47
United Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $380.19 / $478.63	Professional		$125.89	$380.19	$478.63