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 $95.47 / $305.19 / $403.61	Facility		$95.47	$305.19	$403.61
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $87.42 / $301.98 / $614.75	Facility		$87.42	$301.98	$614.75
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