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 $1,405.09 / $1,405.09 / $1,405.09	Facility		$1,405.09	$1,405.09	$1,405.09
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $521.98 / $2,484.11 / $5,056.95	Facility		$521.98	$2,484.11	$5,056.95
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