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
Medica Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $524.81 / $1,000.00	Facility		$95.50	$524.81	$1,000.00
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $457.09 / $1,258.93	Facility		$104.71	$457.09	$1,258.93
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