| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $21,442.45 | $21,442.45 | $21,442.45 | |
Medica
| Professional | $3,704.20 | $3,704.20 | $3,704.20 | |
Midlands
| Facility | $947.15 | $947.15 | $947.15 | |
Midlands
| Professional | $947.15 | $947.15 | $947.15 |