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 / $275.00	Professional		$150.00	$150.00	$275.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Facility		$100.00	$100.00	$100.00
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $2,490.00 / $2,490.00 / $2,490.00	Facility		$2,490.00	$2,490.00	$2,490.00
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $1,967.10 / $2,490.00 / $2,490.00	Professional		$1,967.10	$2,490.00	$2,490.00