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 $55.82 / $80.31 / $131.57	Facility		$55.82	$80.31	$131.57
Medica Facility/Professional Professional Modifier Low / Median / High Price $91.82 / $140.78 / $515.54	Professional		$91.82	$140.78	$515.54
Midlands Facility/Professional Facility Modifier Low / Median / High Price $92.59 / $118.38 / $149.56	Facility		$92.59	$118.38	$149.56
Midlands Facility/Professional Professional Modifier Low / Median / High Price $92.59 / $118.38 / $185.86	Professional		$92.59	$118.38	$185.86
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $110.10 / $110.10 / $110.10	Professional		$110.10	$110.10	$110.10
United Facility/Professional Professional Modifier Low / Median / High Price $87.82 / $127.74 / $217.16	Professional		$87.82	$127.74	$217.16