Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $615.26 / $615.26 / $615.26	Facility		$615.26	$615.26	$615.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $579.07 / $615.26 / $615.26	Professional		$579.07	$615.26	$615.26
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $510.94 / $601.10 / $901.65	Facility		$510.94	$601.10	$901.65
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $601.10 / $601.10 / $601.10	Professional		$601.10	$601.10	$601.10
Cigna Facility/Professional Facility Modifier Low / Median / High Price $615.26 / $615.26 / $615.26	Facility		$615.26	$615.26	$615.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $615.26 / $615.26 / $615.26	Professional		$615.26	$615.26	$615.26
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $522.97 / $615.26 / $615.26	Professional		$522.97	$615.26	$615.26
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $615.26 / $615.26 / $615.26	Facility		$615.26	$615.26	$615.26
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $579.07 / $615.26 / $615.26	Professional		$579.07	$615.26	$615.26
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $615.26 / $615.26 / $615.26	Facility		$615.26	$615.26	$615.26
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $615.26 / $615.26 / $615.26	Professional		$615.26	$615.26	$615.26
United Facility/Professional Professional Modifier Low / Median / High Price $723.84 / $723.84 / $904.80	Professional		$723.84	$723.84	$904.80