| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Hally Health
| Professional | $100.00 | $151.36 | $346.74 | |
Hally Health
| Facility | $100.00 | $100.00 | $100.00 | |
United
| Facility | $37.15 | $64.57 | $100.00 | |
United
| Professional | $56.23 | $75.86 | $112.20 |