Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,175.00 / $7,711.00 / $12,325.00	Facility		$1,175.00	$7,711.00	$12,325.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,450.00 / $1,450.00 / $2,059.00	Facility		$1,450.00	$1,450.00	$2,059.00
Hally Health Facility/Professional Facility Modifier Low / Median / High Price $150.00 / $150.00 / $150.00	Facility		$150.00	$150.00	$150.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $917.71 / $1,600.00 / $15,417.64	Facility		$917.71	$1,600.00	$15,417.64
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $5,897.24 / $27,315.00 / $38,556.00	Facility		$5,897.24	$27,315.00	$38,556.00
United Facility/Professional Facility Modifier Low / Median / High Price $888.00 / $1,744.00 / $13,215.12	Facility		$888.00	$1,744.00	$13,215.12
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $541.00 / $1,327.00 / $18,170.00	Facility		$541.00	$1,327.00	$18,170.00