Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.00 / $70.00 / $226.00	Professional		$70.00	$70.00	$226.00
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $190.57 / $247.51 / $307.82	Professional		$190.57	$247.51	$307.82
Medica Facility/Professional Facility Modifier Low / Median / High Price $37.50 / $70.00 / $115.50	Facility		$37.50	$70.00	$115.50
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 $137.54 / $174.10 / $174.10	Professional		$137.54	$174.10	$174.10