Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $295.12 / $295.12 / $295.12	Facility		$295.12	$295.12	$295.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $281.84 / $346.74	Professional		$223.87	$281.84	$346.74
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $812.83 / $891.25 / $1,348.96	Professional		$812.83	$891.25	$1,348.96
Medica Facility/Professional Facility Modifier Low / Median / High Price $269.15 / $457.09 / $851.14	Facility		$269.15	$457.09	$851.14
Medica Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $512.86 / $1,905.46	Professional		$380.19	$512.86	$1,905.46
Midlands Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $467.74 / $851.14	Professional		$380.19	$467.74	$851.14
Midlands Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $776.25 / $851.14	Professional		$478.63	$776.25	$851.14
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $331.13 / $331.13	Professional		$331.13	$331.13	$331.13
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $707.95 / $707.95	Professional		$707.95	$707.95	$707.95