Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $56.23 / $56.23 / $56.23	Facility		$56.23	$56.23	$56.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $52.48 / $61.66	Professional		$40.74	$52.48	$61.66
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $162.18 / $208.93	Professional		$151.36	$162.18	$208.93
Medica Facility/Professional Facility Modifier Low / Median / High Price $39.81 / $89.13 / $891.25	Facility		$39.81	$89.13	$891.25
Medica Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $123.03 / $354.81	Professional		$70.79	$123.03	$354.81
Midlands Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $102.33 / $138.04	Professional		$69.18	$102.33	$138.04
Midlands Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $123.03 / $138.04	Professional		$72.44	$123.03	$138.04
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $72.44 / $72.44	Professional		$72.44	$72.44	$72.44
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $102.33 / $102.33	Professional		$102.33	$102.33	$102.33