| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $10,798.05 | $10,798.05 | $10,798.05 | |
Medica
| Professional | $2,902.58 | $2,902.58 | $2,902.58 | |
Midlands
| Facility | $529.52 | $529.52 | $529.52 | |
Midlands
| Professional | $529.52 | $529.52 | $529.52 |