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 $97.52 / $97.52 / $100.82	Facility		$97.52	$97.52	$100.82
Medica Facility/Professional Professional Modifier Low / Median / High Price $97.52 / $97.52 / $97.52	Professional		$97.52	$97.52	$97.52
Midlands Facility/Professional Facility Modifier Low / Median / High Price $97.52 / $97.52 / $97.52	Facility		$97.52	$97.52	$97.52
Midlands Facility/Professional Professional Modifier Low / Median / High Price $97.52 / $97.52 / $97.52	Professional		$97.52	$97.52	$97.52
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $81.20 / $81.20 / $81.20	Professional		$81.20	$81.20	$81.20