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 $523.41 / $523.41 / $523.41	Facility		$523.41	$523.41	$523.41
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $116.10 / $162.54 / $330.89	Facility		$116.10	$162.54	$330.89
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