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 $36.18 / $175.80 / $445.03	Facility		$36.18	$175.80	$445.03
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $703.46 / $6,120.96 / $8,946.01	Facility		$703.46	$6,120.96	$8,946.01
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $18,170.00 / $28,440.00 / $40,290.00	Facility		$18,170.00	$28,440.00	$40,290.00