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 $852.71 / $852.71 / $881.82	Facility		$852.71	$852.71	$881.82
Medica Facility/Professional Professional Modifier Low / Median / High Price $852.71 / $852.71 / $852.71	Professional		$852.71	$852.71	$852.71
Midlands Facility/Professional Facility Modifier Low / Median / High Price $852.71 / $852.71 / $852.71	Facility		$852.71	$852.71	$852.71
Midlands Facility/Professional Professional Modifier Low / Median / High Price $852.71 / $852.71 / $852.71	Professional		$852.71	$852.71	$852.71
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $710.00 / $710.00 / $710.00	Professional		$710.00	$710.00	$710.00