| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $10,798.05 | $10,798.05 | $10,798.05 | |
Medica
| Professional | $3,196.32 | $3,196.32 | $3,196.32 | |
Midlands
| Facility | $817.27 | $817.27 | $817.27 | |
Midlands
| Professional | $817.27 | $817.27 | $817.27 |