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 $13.61 / $57.89 / $107.04	Facility		$13.61	$57.89	$107.04
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $4,415.60 / $31,527.72 / $64,181.47	Facility		$4,415.60	$31,527.72	$64,181.47
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