Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $37.42 / $132.82 / $165.75	Professional		$37.42	$132.82	$165.75
Medica Facility/Professional Facility Modifier Low / Median / High Price $25.36 / $78.34 / $129.28	Facility		$25.36	$78.34	$129.28
Medica Facility/Professional Professional Modifier Low / Median / High Price $48.77 / $161.19 / $455.63	Professional		$48.77	$161.19	$455.63
Midlands Facility/Professional Facility Modifier Low / Median / High Price $45.00 / $89.68 / $130.80	Facility		$45.00	$89.68	$130.80
Midlands Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $72.45 / $161.19	Professional		$45.00	$72.45	$161.19
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $66.76 / $84.50 / $84.50	Professional		$66.76	$84.50	$84.50