| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $189.18 | $189.18 | $198.51 | |
Medica
| Professional | $388.15 | $388.15 | $388.15 | |
Midlands
| Facility | $100.83 | $100.83 | $108.26 | |
Midlands
| Professional | $84.62 | $100.83 | $137.53 |