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 $57.61 / $291.25 / $1,803.50	Facility		$57.61	$291.25	$1,803.50
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $3,297.29 / $9,982.19 / $17,241.95	Facility		$3,297.29	$9,982.19	$17,241.95
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