| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Hally Health
| Professional | $75.01 | $79.08 | $138.59 | |
Medica
| Facility | $49.08 | $75.95 | $380.75 | |
Medica
| Professional | $78.66 | $125.96 | $363.86 | |
Midlands
| Facility | $61.07 | $83.52 | $109.65 | |
Midlands
| Professional | $61.07 | $92.91 | $109.65 | |
United
| Professional | $78.66 | $121.57 | $192.70 |