Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $70.00 / $70.00 / $70.00	Facility		$70.00	$70.00	$70.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.00 / $70.00 / $70.00	Professional		$70.00	$70.00	$70.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $35.26 / $70.00 / $118.30	Facility		$35.26	$70.00	$118.30
Medica Facility/Professional Professional Modifier Low / Median / High Price $46.23 / $259.38 / $259.38	Professional		$46.23	$259.38	$259.38
Midlands Facility/Professional Facility Modifier Low / Median / High Price $36.69 / $59.08 / $112.37	Facility		$36.69	$59.08	$112.37
Midlands Facility/Professional Professional Modifier Low / Median / High Price $49.50 / $70.84 / $112.37	Professional		$49.50	$70.84	$112.37
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $174.10 / $174.10 / $174.10	Professional		$174.10	$174.10	$174.10