Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $741.31 / $741.31 / $741.31	Facility		$741.31	$741.31	$741.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $741.31 / $812.83	Professional		$741.31	$741.31	$812.83
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $1,548.82 / $1,862.09 / $2,290.87	Facility		$1,548.82	$1,862.09	$2,290.87
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $1,862.09 / $1,862.09 / $1,862.09	Professional		$1,862.09	$1,862.09	$1,862.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $741.31 / $741.31 / $741.31	Facility		$741.31	$741.31	$741.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $741.31 / $758.58	Professional		$741.31	$741.31	$758.58
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $1,621.81 / $1,905.46	Professional		$154.88	$1,621.81	$1,905.46
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $158.49 / $218.78	Professional		$120.23	$158.49	$218.78
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $741.31 / $741.31 / $741.31	Facility		$741.31	$741.31	$741.31
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $741.31 / $851.14	Professional		$741.31	$741.31	$851.14
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 / $933.25 / $1,905.46	Professional		$125.89	$933.25	$1,905.46