Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Hally Health Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $151.36 / $151.36	Facility		$151.36	$151.36	$151.36
Medica Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $131.83 / $213.80	Facility		$131.83	$131.83	$213.80
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,659.59 / $3,388.44 / $9,549.93	Facility		$1,659.59	$3,388.44	$9,549.93
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $18,197.01 / $28,183.83 / $40,738.03	Facility		$18,197.01	$28,183.83	$40,738.03