Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $812.83 / $1,288.25 / $1,412.54	Facility		$812.83	$1,288.25	$1,412.54
Hally Health Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $151.36 / $151.36	Facility		$151.36	$151.36	$151.36
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,862.09 / $10,000.00 / $18,197.01	Facility		$1,862.09	$10,000.00	$18,197.01
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,412.54 / $1,412.54 / $1,412.54	Facility		$1,412.54	$1,412.54	$1,412.54
United Facility/Professional Facility Modifier Low / Median / High Price $2,290.87 / $10,471.29 / $18,620.87	Facility		$2,290.87	$10,471.29	$18,620.87
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $1,047.13 / $18,197.01 / $40,738.03	Facility		$1,047.13	$18,197.01	$40,738.03