| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Hally Health
| Professional | $151.36 | $151.36 | $151.36 | |
Medica
| Facility | $954.99 | $954.99 | $21,379.62 | |
Medica
| Professional | $954.99 | $3,715.35 | $3,715.35 | |
Midlands
| Professional | $954.99 | $954.99 | $954.99 |