| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $782.73 | $782.73 | $782.73 | |
Medica
| Professional | $2,077.25 | $2,077.25 | $2,077.25 | |
Midlands
| Facility | $752.63 | $752.63 | $1,133.09 | |
Midlands
| Professional | $224.53 | $975.40 | $1,264.41 |