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 $156.04 / $156.04 / $156.04	Facility		$156.04	$156.04	$156.04
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $4,424.25 / $8,848.50 / $12,609.15	Facility		$4,424.25	$8,848.50	$12,609.15
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