Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.00 / $70.00 / $280.00	Professional		$70.00	$70.00	$280.00
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $249.20 / $323.66 / $402.54	Professional		$249.20	$323.66	$402.54
Medica Facility/Professional Facility Modifier Low / Median / High Price $53.44 / $70.00 / $118.30	Facility		$53.44	$70.00	$118.30
Medica Facility/Professional Professional Modifier Low / Median / High Price $53.44 / $259.38 / $259.38	Professional		$53.44	$259.38	$259.38
Midlands Facility/Professional Facility Modifier Low / Median / High Price $36.69 / $70.84 / $112.37	Facility		$36.69	$70.84	$112.37
Midlands Facility/Professional Professional Modifier Low / Median / High Price $41.00 / $70.84 / $112.37	Professional		$41.00	$70.84	$112.37
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $142.28 / $180.10 / $180.10	Professional		$142.28	$180.10	$180.10