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 $41.52 / $99.11 / $195.35	Facility		$41.52	$99.11	$195.35
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $132.62 / $362.04 / $737.02	Facility		$132.62	$362.04	$737.02
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