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 $42.85 / $42.85 / $65.51	Facility		$42.85	$42.85	$65.51
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $68.18 / $613.62 / $1,249.17	Facility		$68.18	$613.62	$1,249.17
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $40.00 / $18,170.00 / $40,290.00	Facility		$40.00	$18,170.00	$40,290.00