| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $418.09 | $418.09 | $418.09 | |
Medica
| Professional | $834.02 | $834.02 | $834.02 | |
Midlands
| Facility | $180.56 | $180.56 | $316.39 | |
Midlands
| Professional | $180.56 | $180.56 | $316.39 | |
Oscar Health
| Professional | $4.00 | $4.00 | $4.00 |