Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $790.00 / $1,583.72 / $3,084.00	Facility		$790.00	$1,583.72	$3,084.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $275.00 / $900.00 / $2,059.00	Facility		$275.00	$900.00	$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 $952.00 / $1,660.00 / $15,417.64	Facility		$952.00	$1,660.00	$15,417.64
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,793.22 / $1,793.22 / $1,801.00	Facility		$1,793.22	$1,793.22	$1,801.00
United Facility/Professional Facility Modifier Low / Median / High Price $848.00 / $1,744.00 / $14,683.36	Facility		$848.00	$1,744.00	$14,683.36
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