| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Hally Health
| Professional | $151.36 | $151.36 | $151.36 | |
Medica
| Facility | $537.03 | $537.03 | $147,910.84 | |
Medica
| Professional | $537.03 | $2,089.30 | $2,089.30 | |
Midlands
| Professional | $537.03 | $537.03 | $537.03 |