| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Hally Health
| Professional | $150.00 | $150.00 | $150.00 | |
Medica
| Facility | $733.03 | $5,900.80 | $10,336.04 | |
Medica
| Professional | $309.39 | $679.21 | $2,005.71 | |
Midlands
| Facility | $733.03 | $2,916.50 | $3,986.14 | |
Midlands
| Professional | $338.59 | $733.03 | $1,067.68 | |
United
| Professional | $290.05 | $584.94 | $808.32 |