Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $69.13 / $69.13 / $69.13	Facility		$69.13	$69.13	$69.13
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 $216.99 / $216.99 / $1,578.03	Facility		$216.99	$216.99	$1,578.03
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $194.36 / $438.90 / $893.48	Facility		$194.36	$438.90	$893.48
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $18,170.00 / $28,440.00 / $40,290.00	Facility		$18,170.00	$28,440.00	$40,290.00