Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $41.69 / $41.69	Facility		$41.69	$41.69	$41.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $41.69 / $56.23	Professional		$33.11	$41.69	$56.23
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $154.88 / $173.78	Professional		$147.91	$154.88	$173.78
Medica Facility/Professional Facility Modifier Low / Median / High Price $46.77 / $72.44 / $147.91	Facility		$46.77	$72.44	$147.91
Medica Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $93.33 / $302.00	Professional		$67.61	$93.33	$302.00
Midlands Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $83.18 / $147.91	Professional		$58.88	$83.18	$147.91
Midlands Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $134.90 / $147.91	Professional		$93.33	$134.90	$147.91
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $81.28 / $81.28	Professional		$81.28	$81.28	$81.28
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $123.03 / $123.03	Professional		$123.03	$123.03	$123.03