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 $95.92 / $524.69 / $1,004.74	Facility		$95.92	$524.69	$1,004.74
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $105.02 / $633.16 / $1,288.93	Facility		$105.02	$633.16	$1,288.93
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