| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Hally Health
| Professional | $75.01 | $79.08 | $138.59 | |
Medica
| Facility | $84.55 | $3,876.07 | $8,465.74 | |
Medica
| Professional | $82.24 | $135.87 | $32,026.29 | |
Midlands
| Facility | $84.55 | $102.18 | $11,095.54 | |
Midlands
| Professional | $84.55 | $118.31 | $11,095.54 | |
United
| Professional | $78.66 | $120.85 | $192.70 |