| 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 | $3,235.94 | $3,890.45 | $6,606.93 | |
United
| Professional | $346.74 | $407.38 | $549.54 |