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 $559.20 / $559.20 / $10,460.00	Facility		$559.20	$559.20	$10,460.00
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $739.49 / $2,553.60 / $5,198.39	Facility		$739.49	$2,553.60	$5,198.39
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