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
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $2,187.76 / $11,481.54 / $15,488.17	Facility		$2,187.76	$11,481.54	$15,488.17
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