| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Hally Health
| Professional | $151.36 | $602.56 | $1,000.00 | |
Medica
| Facility | $281.84 | $21,877.62 | $134,896.29 | |
Medica
| Professional | $128.82 | $218.78 | $912.01 | |
Midlands
| Professional | $251.19 | $794.33 | $1,819.70 | |
United
| Professional | $117.49 | $186.21 | $380.19 |