Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.19 / $10.19 / $50.00	Professional		$10.19	$10.19	$50.00
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $26.88 / $26.88 / $26.88	Professional		$26.88	$26.88	$26.88
Medica Facility/Professional Facility Modifier Low / Median / High Price $90.00 / $90.00 / $248.48	Facility		$90.00	$90.00	$248.48
Medica Facility/Professional Professional Modifier Low / Median / High Price $180.66 / $180.66 / $180.66	Professional		$180.66	$180.66	$180.66
Midlands Facility/Professional Professional Modifier Low / Median / High Price $174.13 / $180.66 / $180.66	Professional		$174.13	$180.66	$180.66
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $194.00 / $194.00 / $194.00	Professional		$194.00	$194.00	$194.00