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 $162.65 / $578.64 / $1,507.35	Facility		$162.65	$578.64	$1,507.35
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $651.24 / $4,734.49 / $8,177.76	Facility		$651.24	$4,734.49	$8,177.76
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