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 $95.50 / $302.00 / $407.38	Facility		$95.50	$302.00	$407.38
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $213.80 / $602.56	Facility		$87.10	$213.80	$602.56
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