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 $1,917.00 / $1,917.00 / $1,917.00	Facility		$1,917.00	$1,917.00	$1,917.00
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $200.00 / $225.00 / $269.00	Facility		$200.00	$225.00	$269.00
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