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 $4.51 / $23.69 / $560.23	Facility		$4.51	$23.69	$560.23
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $5,162.37 / $15,368.64 / $31,286.18	Facility		$5,162.37	$15,368.64	$31,286.18
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