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 $113.25 / $113.25 / $117.22	Facility		$113.25	$113.25	$117.22
Medica Facility/Professional Professional Modifier Low / Median / High Price $113.25 / $113.25 / $113.25	Professional		$113.25	$113.25	$113.25
Midlands Facility/Professional Facility Modifier Low / Median / High Price $113.25 / $113.25 / $113.25	Facility		$113.25	$113.25	$113.25
Midlands Facility/Professional Professional Modifier Low / Median / High Price $113.25 / $113.25 / $113.25	Professional		$113.25	$113.25	$113.25
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $94.30 / $94.30 / $94.30	Professional		$94.30	$94.30	$94.30