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
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $194.93 / $438.59 / $575.07	Facility		$194.93	$438.59	$575.07
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