| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $10,798.05 | $10,798.05 | $10,798.05 | |
Medica
| Professional | $2,818.67 | $2,818.67 | $2,818.67 | |
Midlands
| Facility | $775.74 | $775.74 | $775.74 | |
Midlands
| Professional | $775.74 | $775.74 | $775.74 |