| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $46.89 | $46.89 | $46.89 | |
Medica
| Professional | $73.76 | $73.76 | $73.76 | |
Midlands
| Facility | $46.89 | $46.89 | $46.89 | |
Midlands
| Professional | $46.89 | $46.89 | $73.76 |
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $46.89 | $46.89 | $46.89 | |
Medica
| Professional | $73.76 | $73.76 | $73.76 | |
Midlands
| Facility | $46.89 | $46.89 | $46.89 | |
Midlands
| Professional | $46.89 | $46.89 | $73.76 |