Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.52 / $37.99 / $53.50	Professional		$29.52	$37.99	$53.50
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $134.83 / $137.69 / $149.72	Professional		$134.83	$137.69	$149.72
Medica Facility/Professional Facility Modifier Low / Median / High Price $45.80 / $74.80 / $204.42	Facility		$45.80	$74.80	$204.42
Medica Facility/Professional Professional Modifier Low / Median / High Price $56.78 / $93.95 / $262.88	Professional		$56.78	$93.95	$262.88
Midlands Facility/Professional Facility Modifier Low / Median / High Price $56.39 / $69.39 / $91.34	Facility		$56.39	$69.39	$91.34
Midlands Facility/Professional Professional Modifier Low / Median / High Price $56.39 / $75.69 / $111.61	Professional		$56.39	$75.69	$111.61
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $52.10 / $52.10 / $52.10	Professional		$52.10	$52.10	$52.10
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $103.25 / $130.69 / $130.69	Professional		$103.25	$130.69	$130.69