| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $90.00 | $90.00 | $90.00 | |
Midlands
| Facility | $43.67 | $43.67 | $43.67 | |
Midlands
| Professional | $43.67 | $44.63 | $44.63 | |
United
| Facility | $38.61 | $38.61 | $38.61 |
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $90.00 | $90.00 | $90.00 | |
Midlands
| Facility | $43.67 | $43.67 | $43.67 | |
Midlands
| Professional | $43.67 | $44.63 | $44.63 | |
United
| Facility | $38.61 | $38.61 | $38.61 |