Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Hally Health Facility/Professional Facility Modifier Low / Median / High Price $150.00 / $150.00 / $150.00	Facility		$150.00	$150.00	$150.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $636.00 / $2,753.13 / $16,518.95	Facility		$636.00	$2,753.13	$16,518.95
United Facility/Professional Facility Modifier Low / Median / High Price $550.00 / $1,835.42 / $15,601.07	Facility		$550.00	$1,835.42	$15,601.07
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $190.00 / $18,170.00 / $40,290.00	Facility		$190.00	$18,170.00	$40,290.00