| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Hally Health
| Professional | $138.04 | $151.36 | $245.47 | |
Medica
| Facility | $426.58 | $22,387.21 | $91,201.08 | |
Medica
| Professional | $281.84 | $426.58 | $1,000.00 | |
Midlands
| Professional | $257.04 | $426.58 | $512.86 | |
United
| Professional | $269.15 | $380.19 | $776.25 |