Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $1,412.54 / $1,445.44	Facility		$707.95	$1,412.54	$1,445.44
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 $2,754.23 / $10,964.78 / $18,197.01	Facility		$2,754.23	$10,964.78	$18,197.01
Midlands Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $1,000.00 / $1,258.93	Facility		$1,000.00	$1,000.00	$1,258.93
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,288.25 / $4,570.88 / $6,606.93	Facility		$1,288.25	$4,570.88	$6,606.93
United Facility/Professional Facility Modifier Low / Median / High Price $1,122.02 / $9,549.93 / $18,197.01	Facility		$1,122.02	$9,549.93	$18,197.01
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