Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $22.91 / $22.91 / $22.91	Facility		$22.91	$22.91	$22.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $23.99 / $52.48	Professional		$19.05	$23.99	$52.48
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $107.15 / $117.49	Professional		$93.33	$107.15	$117.49
Medica Facility/Professional Facility Modifier Low / Median / High Price $19.50 / $29.51 / $57.54	Facility		$19.50	$29.51	$57.54
Medica Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $281.84 / $281.84	Professional		$43.65	$281.84	$281.84
Midlands Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $48.98 / $81.28	Professional		$33.11	$48.98	$81.28
Midlands Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $63.10 / $75.86	Professional		$50.12	$63.10	$75.86
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $53.70 / $53.70	Professional		$53.70	$53.70	$53.70
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $67.61 / $67.61	Professional		$67.61	$67.61	$67.61