Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $389.05 / $831.76	Facility		$302.00	$389.05	$831.76
Hally Health Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $151.36 / $151.36	Facility		$151.36	$151.36	$151.36
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $251.19 / $302.00 / $346.74	Facility		$251.19	$302.00	$346.74
United Facility/Professional Facility Modifier Low / Median / High Price $251.19 / $302.00 / $346.74	Facility		$251.19	$302.00	$346.74
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