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 $10,460.00 / $10,460.00 / $10,460.00	Facility		$10,460.00	$10,460.00	$10,460.00
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $3,263.61 / $15,813.32 / $27,313.88	Facility		$3,263.61	$15,813.32	$27,313.88
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