| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Hally Health
| Professional | $150.00 | $150.00 | $150.00 | |
Medica
| Facility | $351.35 | $351.35 | $351.35 | |
Medica
| Professional | $471.24 | $471.24 | $471.24 | |
Midlands
| Professional | $149.47 | $249.13 | $249.13 |