| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Hally Health
| Professional | $120.23 | $199.53 | $2,041.74 | |
Hally Health
| Facility | $100.00 | $100.00 | $100.00 | |
United
| Facility | $5,128.61 | $6,025.60 | $7,079.46 | |
United
| Professional | $812.83 | $1,148.15 | $1,737.80 |