| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Hally Health
| Professional | $137.69 | $206.53 | $242.83 | |
Medica
| Facility | $404.96 | $18,797.00 | $81,336.71 | |
Medica
| Professional | $279.13 | $521.34 | $1,169.18 | |
Midlands
| Facility | $427.05 | $39,775.33 | $55,196.95 | |
Midlands
| Professional | $258.99 | $459.81 | $543.79 | |
United
| Professional | $279.13 | $539.66 | $777.89 |