| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $3,745.74 | $4,234.85 | $9,955.87 | |
Medica
| Professional | $3,745.74 | $10,335.39 | $15,126.48 | |
Midlands
| Facility | $3,745.74 | $4,234.85 | $5,815.48 | |
Midlands
| Professional | $3,745.74 | $5,231.18 | $10,335.39 |