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 $589.01 / $589.01 / $589.01	Facility		$589.01	$589.01	$589.01
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $138.94 / $936.18 / $1,905.80	Facility		$138.94	$936.18	$1,905.80
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