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 $94.28 / $94.28 / $97.52	Facility		$94.28	$94.28	$97.52
Medica Facility/Professional Professional Modifier Low / Median / High Price $94.28 / $94.28 / $94.28	Professional		$94.28	$94.28	$94.28
Midlands Facility/Professional Facility Modifier Low / Median / High Price $94.28 / $94.28 / $94.28	Facility		$94.28	$94.28	$94.28
Midlands Facility/Professional Professional Modifier Low / Median / High Price $94.28 / $94.28 / $94.28	Professional		$94.28	$94.28	$94.28
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $78.50 / $78.50 / $78.50	Professional		$78.50	$78.50	$78.50