| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Hally Health
| Professional | $346.74 | $562.34 | $794.33 | |
Hally Health
| Facility | $100.00 | $100.00 | $100.00 | |
Hally Health
| Professional | $446.68 | $501.19 | $562.34 | |
United
| Facility | $4,168.69 | $5,370.32 | $7,079.46 | |
United
| Professional | $436.52 | $660.69 | $1,258.93 |