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 $1,161.00 / $1,161.00 / $1,161.00	Facility		$1,161.00	$1,161.00	$1,161.00
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $783.63 / $18,174.50 / $36,998.06	Facility		$783.63	$18,174.50	$36,998.06
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