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 $165.11 / $165.11 / $186.76	Facility		$165.11	$165.11	$186.76
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,618.06 / $22,833.76 / $39,440.12	Facility		$1,618.06	$22,833.76	$39,440.12
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