Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $141.25 / $141.25	Facility		$141.25	$141.25	$141.25
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 $27.54 / $100.00 / $2,041.74	Facility		$27.54	$100.00	$2,041.74
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $741.31 / $2,041.74	Facility		$89.13	$741.31	$2,041.74
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $18,197.01 / $28,183.83 / $40,738.03	Facility		$18,197.01	$28,183.83	$40,738.03