| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Hally Health
| Professional | $151.36 | $151.36 | $151.36 | |
Medica
| Facility | $251.19 | $7,079.46 | $10,471.29 | |
Medica
| Professional | $128.82 | $208.93 | $457.09 | |
Midlands
| Professional | $186.21 | $281.84 | $707.95 | |
United
| Professional | $117.49 | $186.21 | $363.08 |