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 $379.88 / $379.88 / $379.88	Facility		$379.88	$379.88	$379.88
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,965.75 / $3,101.59 / $6,313.95	Facility		$1,965.75	$3,101.59	$6,313.95
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