Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $150.00 / $150.00 / $150.00	Professional		$150.00	$150.00	$150.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $256.64 / $256.64 / $313.70	Facility		$256.64	$256.64	$313.70
Medica Facility/Professional Professional Modifier Low / Median / High Price $313.70 / $802.69 / $802.69	Professional		$313.70	$802.69	$802.69
Midlands Facility/Professional Facility Modifier Low / Median / High Price $313.70 / $313.70 / $313.70	Facility		$313.70	$313.70	$313.70
Midlands Facility/Professional Professional Modifier Low / Median / High Price $313.70 / $313.70 / $313.70	Professional		$313.70	$313.70	$313.70