Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Hally Health Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $151.36 / $151.36	Facility		$151.36	$151.36	$151.36
Medica Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $912.01 / $1,412.54	Facility		$707.95	$912.01	$1,412.54
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,096.48 / $3,162.28 / $4,570.88	Facility		$1,096.48	$3,162.28	$4,570.88
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $18,197.01 / $28,183.83 / $40,738.03	Facility		$18,197.01	$28,183.83	$40,738.03