| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Hally Health
| Professional | $120.23 | $199.53 | $346.74 | |
Hally Health
| Facility | $100.00 | $100.00 | $100.00 | |
United
| Facility | $6,918.31 | $10,471.29 | $16,595.87 | |
United
| Professional | $588.84 | $691.83 | $912.01 |